Towards a Communication Framework for Empowerment in Osteoarthritis Care

Behera, Naomi Simick; Bunzli, Samantha

doi:10.1016/j.cger.2021.11.004

Cited by 10 publications

(6 citation statements)

References 61 publications

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“…While low expectations of benefit may indicate an individual’s accurate assessment of their condition,46 they may also reflect unhelpful beliefs regarding the amenableness of knee osteoarthritis to non-surgical management47 or unrealistic perceptions of the likely benefit of total joint arthroplasty 48. From a biomedical lens, prevailing views of the affected joint as ‘damaged’ and beyond the patient’s control may predispose a patient to more guarded expectations, when in fact symptoms may be impacted by modifiable factors within their control 49–51. Similarly, multiple factors affect knee function which may include both physical and psychological mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…48 From a biomedical lens, prevailing views of the affected joint as 'damaged' and beyond the patient's control may predispose a patient to more guarded expectations, when in fact symptoms may be impacted by modifiable factors within their control. [49][50][51] Similarly, multiple factors affect knee function which may include both physical and psychological mechanisms. Knee function has demonstrated relationships with anxiety, fear avoidance and fear of movement 27 52 that may adversely impact participation in physical activity and subsequent progression of disability through an avoidance cycle.…”

Section: Open Accessmentioning

confidence: 99%

See 1 more Smart Citation

Prospective validity of a clinical prediction rule for response to non-surgical multidisciplinary management of knee osteoarthritis in tertiary care: a multisite prospective longitudinal study

Window,

Raymer,

McPhail

et al. 2024

BMJ Open

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ObjectivesWe tested a previously developed clinical prediction tool—a nomogram consisting of four patient measures (lower patient-expected benefit, lower patient-reported knee function, greater knee varus angle and severe medial knee radiological degeneration) that were related to poor response to non-surgical management of knee osteoarthritis. This study sought to prospectively evaluate the predictive validity of this nomogram to identify patients most likely to respond poorly to non-surgical management of knee osteoarthritis.DesignMultisite prospective longitudinal study.SettingAdvanced practice physiotherapist-led multidisciplinary service across six tertiary hospitals.ParticipantsParticipants with knee osteoarthritis deemed appropriate for trial of non-surgical management following an initial assessment from an advanced practice physiotherapist were eligible for inclusion.InterventionsBaseline clinical nomogram scores were collected before a trial of individualised non-surgical management commenced.Primary outcome measureClinical outcome (Global Rating of Change) was collected 6 months following commencement of non-surgical management and dichotomised to responder (a little better to a very great deal better) or poor responder (almost the same to a very great deal worse). Clinical nomogram accuracy was evaluated from receiver operating characteristics curve analysis and area under the curve, and sensitivity/specificity and positive/negative likelihood ratios were calculated.ResultsA total of 242 participants enrolled. Follow-up scores were obtained from 210 participants (87% response rate). The clinical nomogram demonstrated an area under the curve of 0.70 (p<0.001), with greatest combined sensitivity 0.65 and specificity 0.64. The positive likelihood ratio was 1.81 (95% CI 1.32 to 2.36) and negative likelihood ratio 0.55 (95% CI 0.41 to 0.75).ConclusionsThe knee osteoarthritis clinical nomogram prediction tool may have capacity to identify patients at risk of poor response to non-surgical management. Further work is required to determine the implications for service delivery, feasibility and impact of implementing the nomogram in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Open Accessmentioning

confidence: 99%

Prospective validity of a clinical prediction rule for response to non-surgical multidisciplinary management of knee osteoarthritis in tertiary care: a multisite prospective longitudinal study

Window,

Raymer,

McPhail

et al. 2024

BMJ Open

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“…However, bringing about consistent participatory messaging from all voices including health professionals and carers may have the greatest impact on improving physical activity levels and health outcomes after knee replacement (Behera & Bunzli, 2022).…”

Section: Discussionmentioning

confidence: 99%

“…Changing the health discourse is challenging and likely to require sustained public health campaigns and reforming the reimbursement models of health systems that incentivise surgical intervention for knee osteoarthritis over conservative management (Wallis et al., 2020). However, bringing about consistent participatory messaging from all voices including health professionals and carers may have the greatest impact on improving physical activity levels and health outcomes after knee replacement (Behera & Bunzli, 2022).…”

Section: Discussionmentioning

confidence: 99%

Does a consumer co‐designed infographic increase knowledge of physical activity after total knee joint replacement? A randomised controlled trial

Hawke,

Shields,

Dowsey

et al. 2023

Musculoskeletal Care

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PurposeTo determine if a consumer co‐designed infographic increased knowledge of physical activity and self‐efficacy for exercise after total knee joint replacement surgery.MethodsForty‐four adults with primary knee joint replacement surgery were recruited from a public and a private hospital in Melbourne, Australia. Participants were randomly allocated to an experimental or control group. The experimental group received a consumer co‐designed infographic. All participants received usual care. Primary outcome measures were knowledge of physical activity and self‐efficacy for exercise. Outcomes were administered at baseline, week 1 and week 6. Semi‐structured interviews with experimental group participants explored the acceptability, implementation and efficacy of the infographic.ResultsThere were no between‐group differences for knowledge of physical activity at week 1 (MD −0.02 units, 95% CI −0.9 to 0.9) or week 6 (MD 0.01 units, 95% CI −0.9 to 0.9). Self‐efficacy for exercise increased at week 1 (MD 14.2 units, 95% CI 2.9–25.4) but was not sustained. Qualitative data showed that the infographic was embraced by some participants but not by others.ConclusionsA consumer co‐designed infographic did not improve knowledge of physical activity but may have had a short‐term positive effect on self‐efficacy for exercise after knee joint replacement. Trial registration ACTRN12621000910808.

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“…In the context of the present discussion, empowerment is the outcome of a partnership between veterinarian and caregiver in which the latter is provided with knowledge, resources and tools, and is given authority to make informed decisions related to the cat's treatment. 65 The 'caregiver burden' Unfortunately, when long-term medication is initiated, caregivers are not always given information on how to medicate their cat. 60 Accompanying guides on treating chronic pain with NSAIDs (see 'Resources for caregivers') are intended to help address this problem.…”

Section: Supporting Caregivers In Medicating Cats With Nsaids Caregiv...mentioning

confidence: 99%

2024 ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats

Taylor,

Gruen,

KuKanich

et al. 2024

Journal of Feline Medicine and Surgery

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Practical relevance: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and are effective for the management of pain in cats. These Guidelines will support veterinarians in decision-making around prescribing NSAIDs in situations of chronic pain, to minimise adverse effects and optimise pain management. Information is provided on mechanism of action, indications for use, screening prior to prescription, use in the presence of comorbidities, monitoring of efficacy, and avoidance and management of adverse effects. Clinical challenges: The cat's unique metabolism should be considered when prescribing any medications, including NSAIDs. Chronic pain may be challenging to detect in this species and comorbidities, particularly chronic kidney disease, are common in senior cats. Management of chronic pain may be complicated by prescription of other drugs with the potential for interactions with NSAIDs. Evidence base: These Guidelines have been created by a panel of experts brought together by the International Society of Feline Medicine (ISFM) and American Association of Feline Practitioners (AAFP). Information is based on the available literature, expert opinion and the panel members' experience.

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Towards a Communication Framework for Empowerment in Osteoarthritis Care

Cited by 10 publications

References 61 publications

Prospective validity of a clinical prediction rule for response to non-surgical multidisciplinary management of knee osteoarthritis in tertiary care: a multisite prospective longitudinal study

Prospective validity of a clinical prediction rule for response to non-surgical multidisciplinary management of knee osteoarthritis in tertiary care: a multisite prospective longitudinal study

Does a consumer co‐designed infographic increase knowledge of physical activity after total knee joint replacement? A randomised controlled trial

2024 ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats

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