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Participation in a digital self-management intervention for osteoarthritis and socioeconomic inequalities in patient-related outcomes

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Title: Participation in a digital self-management intervention for osteoarthritis and socioeconomic inequalities in patient-related outcomes
Authors: Mahmoudian, A, Lohmander, L S, Dahlberg, L E, Kiadaliri, A
Contributors: Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lund OsteoArthritis Division - Clinical Epidemiology Unit, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Lund OsteoArthritis Division - Clinical Epidemiology Unit, Originator, Lund University, Profile areas and other strong research environments, Strategic research areas (SRA), EpiHealth: Epidemiology for Health, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Strategiska forskningsområden (SFO), EpiHealth: Epidemiology for Health, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lund OsteoArthritis Division - Molecular marker research group, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Lund OsteoArthritis Division - Nedbrytning av ledbrosk: en biologisk process som leder till artros, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lund OsteoArthritis Division - From molecule to clinical implementation, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Lund OsteoArthritis Division - From molecule to clinical implementation, Originator
Source: Scandinavian Journal of Rheumatology. 54(1):33-40
Subject Terms: Medical and Health Sciences, Health Sciences, Physiotherapy, Medicin och hälsovetenskap, Hälsovetenskap, Fysioterapi
Description: OBJECTIVE: To investigate changes in socioeconomic inequalities in patient-related outcomes and pain medication use, following participation in a digital self-management intervention for osteoarthritis (OA) in Sweden. METHOD: Participants with hip/knee OA enrolled in the digital intervention were included. Self-reported outcomes collected were the numerical rating scale (NRS) pain, activity impairment, general health, Knee/Hip injury and Osteoarthritis Outcome Score (KOOS-12, HOOS-12) Pain, Function, and Quality of Life subscales, 5-level EuroQol 5 Dimensions (EQ-5D-5L), Patient Acceptable Symptom State (PASS) for function, walking difficulties, fear of movement, wish for surgery, pain medication use, physical function measured by the 30s chair-stand test, and level of physical activity. Educational attainment was used as a socioeconomic measure and the concentration index was used to assess the magnitude of inequalities at baseline and 3 month follow-up. RESULTS: The study included 21,688 participants (mean ± sd age 64.1 ± 9.1 years, 74.4% females). All outcomes except for PASS demonstrated inequalities in favour of highly educated participants at both time-points, with highly educated participants reporting better outcomes. At 3 month follow-up, the magnitude of inequality widened for activity impairment, but narrowed for NRS pain, EQ-5D-5L, KOOS-12/HOOS-12 Pain and Function, physical function, and wish for surgery. There were no statistically conclusive changes in the magnitude of inequalities for the remaining outcomes. CONCLUSIONS: There were inequalities in patient-related outcomes in favour of those with higher education among participants of a digital self-management intervention for OA, although the magnitude of these pre-existing inequalities generally narrowed after the 3 month intervention.
Access URL: https://doi.org/10.1080/03009742.2024.2361542
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  Data: Participation in a digital self-management intervention for osteoarthritis and socioeconomic inequalities in patient-related outcomes
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  Data: Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lund OsteoArthritis Division - Clinical Epidemiology Unit, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Lund OsteoArthritis Division - Clinical Epidemiology Unit, Originator<br />Lund University, Profile areas and other strong research environments, Strategic research areas (SRA), EpiHealth: Epidemiology for Health, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Strategiska forskningsområden (SFO), EpiHealth: Epidemiology for Health, Originator<br />Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lund OsteoArthritis Division - Molecular marker research group, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Lund OsteoArthritis Division - Nedbrytning av ledbrosk: en biologisk process som leder till artros, Originator<br />Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Originator<br />Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section III, Orthopaedics (Lund), Lund OsteoArthritis Division - From molecule to clinical implementation, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion III, Ortopedi, Lund, Lund OsteoArthritis Division - From molecule to clinical implementation, Originator
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  Data: OBJECTIVE: To investigate changes in socioeconomic inequalities in patient-related outcomes and pain medication use, following participation in a digital self-management intervention for osteoarthritis (OA) in Sweden. METHOD: Participants with hip/knee OA enrolled in the digital intervention were included. Self-reported outcomes collected were the numerical rating scale (NRS) pain, activity impairment, general health, Knee/Hip injury and Osteoarthritis Outcome Score (KOOS-12, HOOS-12) Pain, Function, and Quality of Life subscales, 5-level EuroQol 5 Dimensions (EQ-5D-5L), Patient Acceptable Symptom State (PASS) for function, walking difficulties, fear of movement, wish for surgery, pain medication use, physical function measured by the 30s chair-stand test, and level of physical activity. Educational attainment was used as a socioeconomic measure and the concentration index was used to assess the magnitude of inequalities at baseline and 3 month follow-up. RESULTS: The study included 21,688 participants (mean ± sd age 64.1 ± 9.1 years, 74.4% females). All outcomes except for PASS demonstrated inequalities in favour of highly educated participants at both time-points, with highly educated participants reporting better outcomes. At 3 month follow-up, the magnitude of inequality widened for activity impairment, but narrowed for NRS pain, EQ-5D-5L, KOOS-12/HOOS-12 Pain and Function, physical function, and wish for surgery. There were no statistically conclusive changes in the magnitude of inequalities for the remaining outcomes. CONCLUSIONS: There were inequalities in patient-related outcomes in favour of those with higher education among participants of a digital self-management intervention for OA, although the magnitude of these pre-existing inequalities generally narrowed after the 3 month intervention.
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