Empowerment and enablement as predictors of change in health-related quality of life among patients participating in a Supported OsteoArthritis Self-Management Programme – a prospective observational study

Abstract

Background: Osteoarthritis is a leading cause of disability worldwide. Current treatment supports coping strategies to improve health-related quality of life (HRQoL). The need to predict response to treatment has been raised to personalise care. This study aims to examine change in HRQoL from baseline to three and nine months follow-up after participating in a Supported OsteoArthritis Self-Management Programme (SOASP) and to examine if empowerment and/or enablement could predict change in HRQoL among patients participating in a SOASP. Methods: Patients participating in a SOASP were recruited consecutively between April 2016 and June 2018. The EQ-5D was used to measure HRQoL, the SWE-RES-23 23 (score range 1–5) to measure empowerment and the PEI (score range 0–12) to measure enablement. The instruments were answered before (EQ-5D, SWE-RES-23) and after (EQ-5D, SWE-RES-23, PEI) the SOASP. A patient partner was engaged to enhance the patient perspective. Changes in outcome were examined with paired sample t-test and standardized effect sizes (Cohen´s d). Potential predictive variables were tested with multiple linear regression analysis. Results: In total, 143 patients participated in baseline measurement. The mean EQ-5D-5L index score increased significantly from baseline to three months corresponding to a standardised effect size (Cohen´s d) of d=.43, 95 % CI [.24, .63] (n=109), and from baseline to nine months d=.19, 95 % CI [.01, .37] (n=119). The average EQ VAS score increased significantly from baseline to three months corresponding to a standardised effect size of d=.26, 95 % CI [.07, .45] (n=109), and from baseline to nine months d=.18, 95 % CI [.00, .36] (n=119). Neither the SWE-RES-23 nor the PEI at three months follow-up or the change in the SWE-RES-23 score from baseline to three months follow-up predicted change in either EQ-5D-5L index (p>.05) or the EQ VAS (p>.05). Conclusions: Health-related quality of life increased after participating in a SOASP. Empowerment and enablement as measured with the SWE-RES-23 and the PEI respectively could not predict change in HRQoL among patients participating in a SOASP. Trial registration: ClinicalTrials.gov. Identification number: NCT 02974036. First registration 28/11/2016, retrospectively registered.