Author: Ladan Sahafi
Sahafi, Ladan, 2019 A randomised controlled trial evaluating the use of a self-management support intervention program to improve the quality of life in obese osteoarthritis patients awaiting hip or knee arthroplasty, Flinders University, College of Medicine and Public Health
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Osteoarthritis is a leading cause of disability and has a significant impact on health-related quality of life. The prevalence of hip or knee osteoarthritis continues to rise, due to an ageing population and the increasing prevalence of obesity. The treatment of choice for end-stage hip and knee osteoarthritis patients suffering extensive pain and deformity is arthroplasty or total joint replacement when other treatments have failed. Obesity is acknowledged as the most modifiable risk factor for both osteoarthritis and total hip or knee replacement.
The aim of this study was to introduce interventions that addressed the lifestyle and comorbidity problems faced by patients with obesity on a hip or knee joint replacement waiting list in order to improve their health-related quality of life prior to and following joint replacement surgery.
This study was a two-group randomised, parallel trial with obese osteoarthritis patients on a total hip or knee replacement waiting list at the Repatriation General Hospital in Adelaide, South Australia. The study sought to test the efficacy of a self-management support intervention program to improve health-related quality of life. A blocked randomisation method with stratification at gender and body mass index (BMI) groups was used to randomise eligible patients to either a control group receiving usual care or an intervention group receiving the telephone-delivered Flinders Program based self-management support program for six months.
Participants in the intervention group achieved a significantly greater improvement in the emotional role domain of SF36 than in the control group (p=0.009), but not in other SF36 domains. For the second primary outcome OAKHQoL, the differences in improvements of physical activity, mental health, social activities and spouse relation scores across time were significant in favour of the intervention group (p<0.050) and social support approaching significance (p=0.070).
This study showed the Flinders Program based self-management support program helps obese osteoarthritis patients awaiting total hip or knee replacement mentally, socially and in some cases physically and is worth considering in clinics and hospitals.
Keywords: Obesity,Osteoarthritis,Arthroplasty,Self-management,Weight-loss
Subject: Medicine thesis
Thesis type: Doctor of Philosophy
Completed: 2019
School: College of Medicine and Public Health
Supervisor: Professor Malcolm Battersby