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

IF 2.2 4区 医学 Q3 RHEUMATOLOGY Scandinavian Journal of Rheumatology Pub Date : 2024-06-20 DOI:10.1080/03009742.2024.2361542
A Mahmoudian, L S Lohmander, L E Dahlberg, A Kiadaliri
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Abstract

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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参与骨关节炎数字化自我管理干预与患者相关结果的社会经济不平等。
目的调查在瑞典参加骨关节炎(OA)数字化自我管理干预后,患者相关结果和止痛药使用方面的社会经济不平等的变化:方法:纳入参加数字化干预的髋关节/膝关节 OA 患者。收集的自我报告结果包括疼痛、活动障碍、一般健康状况、膝/髋损伤和骨关节炎结果评分(KOOS-12、HOOS-12)疼痛、功能和生活质量分量表、5级EuroQol 5维度(EQ-5D-5L)、患者功能可接受症状状态(PASS)、行走困难、运动恐惧、手术意愿、止痛药使用情况、30s椅子站立测试测量的身体功能以及体育活动水平。教育程度作为社会经济衡量标准,集中指数用于评估基线和 3 个月随访时的不平等程度:研究包括 21688 名参与者(平均年龄为 64.1±9.1 岁,女性占 74.4%)。除 PASS 外,其他所有结果在两个时间点均显示出有利于高学历参与者的不平等,高学历参与者报告的结果更好。在 3 个月的随访中,活动障碍方面的不平等程度有所扩大,但在 NRS 疼痛、EQ-5D-5L、KOOS-12/HOOS-12 疼痛和功能、身体功能以及手术意愿方面的不平等程度有所缩小。其余结果的不平等程度在统计学上没有决定性的变化:结论:在OA数字化自我管理干预的参与者中,受教育程度较高的人在患者相关结果方面更占优势,但在3个月的干预后,这些先前存在的不平等程度普遍有所缩小。
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来源期刊
CiteScore
3.70
自引率
4.80%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Scandinavian Journal of Rheumatology is the official journal of the Scandinavian Society for Rheumatology, a non-profit organization following the statutes of the Scandinavian Society for Rheumatology/Scandinavian Research Foundation. The main objective of the Foundation is to support research and promote information and knowledge about rheumatology and related fields. The annual surplus by running the Journal is awarded to young, talented, researchers within the field of rheumatology.pasting The Scandinavian Journal of Rheumatology is an international scientific journal covering clinical and experimental aspects of rheumatic diseases. The journal provides essential reading for rheumatologists as well as general practitioners, orthopaedic surgeons, radiologists, pharmacologists, pathologists and other health professionals with an interest in patients with rheumatic diseases. The journal publishes original articles as well as reviews, editorials, letters and supplements within the various fields of clinical and experimental rheumatology, including; Epidemiology Aetiology and pathogenesis Treatment and prophylaxis Laboratory aspects including genetics, biochemistry, immunology, immunopathology, microbiology, histopathology, pathophysiology and pharmacology Radiological aspects including X-ray, ultrasonography, CT, MRI and other forms of imaging.
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