Can an intervention on clinical inertia have an impact on the perception of pain,functionality and quality of life in patients with hip and/or knee osteoarthritis? Results from a cluster randomised trial

ObjectivesEvaluate whether an intervention applied to general practitioners to prevent clinical inertia had an impact on pain, functionality, and health-related quality of life (HRQoL) of patients with hip and/or knee osteoarthritis.DesignThis was a cluster-based, multicentre, prospective, randomized, parallel-group study. Clusters of physicians working were assigned to one of two study groups. Physicians in Group 1 received a training session while those in Group 2 did not.SettingPrimary Care Health centers representative of the entire Spanish territory.Participants329 general practitioners of primary healthcare centre.InterventionsThe intervention consists of a motivational session to propose a proactive care, based on current recommendations.MeasurementsVisual analogue scale (VAS); functionality (WOMAC scale) and global perception of health by SF-12. Effects were measured in two visits six months apart.ResultsA total of 1361 physicians, and 4076 patients participated in the study. No significant differences were observed in the clinical benefit obtained between patients assigned to Group 1 and Group 2. Nevertheless, a significant improvement was observed in the combined population (Groups 1 + 2) in the VAS (p < 0.001), WOMAC (p < 0.0001) and SF-12v2 (p < 0.001) questionnaires in Visit 2 compared to Visit 1.ConclusionsThe results indicate that, although this specific intervention carried out on physicians did not provide an additional clinical benefit to patients with knee and/or hip osteoarthritis, an increased awareness of the patient's disease through the use of functionality indexes, as well as the mere fact of being observed, seem to improve patient-reported pain, functionality and HRQoL.