Comparison of Face-to-Face vs Digital Delivery of an Osteoarthritis Treatment Program for Hip or Knee Osteoarthritis

• DOI: 10.1001/jamanetworkopen.2022.40126
• Publication Date: 2022-11-03T15:32:06Z
• Authors: Therese Jönsson; Andrea Dell’Isola; L. Stefan Lohmander; Philippe Wagner; Anna Cronström
• Keywords: Modalities; Knee pain

Importance Digital care platforms have been introduced, but there is limited evidence for their efficacy compared with traditional face-to-face treatment modalities. Objective To compare mean pain reduction among individuals osteoarthritis (OA) of the knee or hip who underwent vs digital first-line intervention. Design, Setting, and Participants This registry-based cohort study included all persons participated in structured a primary setting Sweden. Inclusion criteria were as follows: was delivered digitally between April 1, 2018, December 31, 2019; patients provided 3-month follow-up data pain; had program adherence at least 80%. Data analysis conducted March 2021. Exposures completed intervention, including education exercise osteoarthritis, 80% higher, by application. Main Outcomes Measures Difference change joint (11-point numeric rating scale, 0 indicating no 10, worst possible pain) baseline 2 intervention A minimal clinically important difference groups predefined 1 point. Secondary outcomes walking difficulties, health-related quality life, willingness to undergo surgery, fear avoidance behavior. Results total 6946 participants (mean [SD] age, 67 [9] years; 4952 [71%] women; 4424 [64%] OA; 2504 [36%] OA) included, 4237 (61%) receiving 2709 (39%) treatment. Both change, −1.10 [95% CI −1.17 −1.02] points) interventions −1.87 CI, −1.94 −1.79] resulted 3 months. experienced larger estimated improvement months (adjusted difference, −0.93 −1.04 −0.81] points). secondary broadly consistent main outcome. Conclusions Relevance Swedish national showed that people OA participating relevant improvements pain, whether digitally. The increased benefit delivery uncertain clinical importance.