Op0156 hpr the Feasibility and Effectiveness of Telemedicine for Knee Osteoarthritis in Disease Management: A Randomised Control Trial

Abstract

BackgroundOsteoarthritis (OA) is a serious health concern worldwide, and patients with OA are in urgent need of proper long-term disease management to prevent disability and improve the quality of life. Research has started to investigate the feasibility and effectiveness of telemedicine in providing disease management for patients with chronic diseases. Guangdong Online Hospital (GOH) is the first officially recognized web-based hospital that widely provides telemedicine services in southern China.ObjectivesThis study aimed to establish the feasibility and effectiveness of GOH in providing long-term disease management for patients with knee OA via a 6-month, randomised control trial (RCT).Methods40 patients with knee OA were randomly assigned to receive conventional therapy (CT) in the clinic or conventional therapy plus a brief GOH-based intervention (CT-GOHT). GOH-based intervention included educational lectures, medical suggestions and psychotherapy. The primary outcome was the drop-out rates and the secondary outcomes included the mean change of the self-reported total score of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Multidimensional Fatigue Inventory (MFI), the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI) from baseline to endpoint.Figure 1Flow chat of trial participationFigure 2A telemedicine intervention to patients with knee OAResultsThe baseline characteristics were comparable between the two groups. 3 patients in CT group and 1 patient in CT-GOHT group lost to follow-up during the study (P = 0.598). A statistically significant difference was observed in the mean change of WOMAC recommended index of joint pain (8.82 ± 5.02 vs. 13.90 ± 7.63, P = 0.026), morning stiffness (3.12 ± 1.50 vs. 4.42 ± 2.06, P = 0.039), functional limitation (27.65 ± 9.91 vs. 38.84 ± 17.28, P = 0.025), HADS-Anxiety (3.24 ± 2.41 vs. 5.32 ± 3.23, P = 0.037), and PSQI global score (2.35 ± 1.54 vs. 4.21 ± 3.34, P = 0.043) from baseline to endpoint when comparing the CT group to the CT-GOHT group. In addition, Guangdong Online Hospital was widely accepted by the including OA patients for their disease management.ConclusionDelivering a telemedicine intervention to patients with knee OA via GOH is a feasible and potentially effective method in long-term disease management, especially for patients living in remote areas. The results provide preliminary experiences and guidance for an upcoming full-scale RCT in disease management via telemedicine.Trial registrationChiCTR1800014465.Reference[1] Huang Z, et al. Implementation of telemedicine for knee osteoarthritis: study protocol for a randomized controlled trial. Trials, 2018, 19(1):232.Table 1Baseline characteristics of the two study groupsVariableCT group(n = 20)CT-GOH group(n = 20)Age72.25 ± 8.8467.25 ± 10.97Female, n1515Education, nPrimary schoolHigh school128146Han Chinese, n2020Income, n<¥2000¥2000 -¥5000>¥5000 81025132BMI, kg/m2 25.85 ± 3.8726.29 ± 2.96Distance to hospital, kilometre105.83 ± 100.35...

Effect of Internet-Based Rehabilitation Programs on Improvement of Pain and Physical Function in Patients with Knee Osteoarthritis: Systematic Review and Meta-analysis of Randomized Controlled Trials

“…The baseline descriptive characteristics (country, sample size, age, and gender) of the 6 studies included in the systematic review are summarized in Table 1 . Two studies were from the United States [ 35 , 51 ], one from Australia [ 33 ], one from China [ 34 ], one from Brazil [ 52 ], and one from the Netherlands [ 53 ]. The mean age of patients with knee OA ranged from 53.1 (SD 8.5) to 72.25 (SD 8.84) years, and all studies included both men and women.…”

“…Each module took 35 to 45 minutes to complete [ 51 ]. Huang and colleagues [ 34 ] from China developed an internet-based rehabilitation program for patients with knee OA comprised of three broad segments: encouragement, educational lectures, and medical issues, each of which could be completed within 20-30 min in an independent manner. In Australia, O’Moore and colleagues [ 33 ] studied the effectiveness of an internet-based cognitive-behavioral therapy (iCBT) program for older adults with knee OA.…”

“…Despite the increasing popularity of these internet-based rehabilitation programs, there is insufficient evidence to demonstrate their effectiveness for patients with knee OA. Positive results have been shown in some studies in which specific programs of internet-based rehabilitation could improve pain and physical function for patients with knee OA as compared with conventional rehabilitation [ 33 , 34 ]. However, different views have also been put forth, indicating no significant change in OA-related pain and physical function during long-term follow up of 12 months [ 35 , 36 ].…”

Effect of Internet-Based Rehabilitation Programs on Improvement of Pain and Physical Function in Patients with Knee Osteoarthritis: Systematic Review and Meta-analysis of Randomized Controlled Trials (Preprint)

“…The baseline descriptive characteristics (country, sample size, age, and gender) of the 6 studies included in the systematic review are summarized in Table 1. Two studies were from the United States [35,51], one from Australia [33], one from China [34], one from Brazil [52], and one from the Netherlands [53]. The mean age of patients with knee OA ranged from 53.1 (SD 8.5) to 72.25 (SD 8.84) years, and all studies included both men and women.…”

“…Despite the increasing popularity of these internet-based rehabilitation programs, there is insufficient evidence to demonstrate their effectiveness for patients with knee OA. Positive results have been shown in some studies in which specific programs of internet-based rehabilitation could improve pain and physical function for patients with knee OA as compared with conventional rehabilitation [33,34]. However, different views have also been put forth, indicating no significant change in OA-related pain and physical function during long-term follow up of 12 months [35,36].…”