UNASSIGNED: This open study assessed an OAMP designed to deliver care in 1-5 individual or group visits across ≤12 months. Eligibility included adults with knee or hip osteoarthritis with ≥1 visit from 7/1/2017-1/15/2021. A multidisciplinary care team provided: education on osteoarthritis, self-management, exercise, weight loss; pharmacologic management; assessments of mood, sleep, quality of life, and diet. Clinic utilization and growth are reported through 2022. Patient outcomes of body mass index (BMI), pain, and function were analyzed using multivariable general linear models. OAMP outcomes were feasibility and sustainability.
UNASSIGNED: Most patients were locally referred by primary care. 953 patients attended 2531 visits (average visits 2.16, treatment duration 187.9 days). Most were female (72.6%), older (62.1), white (91.1%), and had medical insurance (95.4%). Obesity was prevalent (84.7% BMI ≥30, average BMI 40.9), mean Charlson Comorbidity Index was 1.89, and functional testing was below average. Longitudinal modeling revealed statistically but not clinically significant pain reduction (4.4-3.9 on 0-10 scale, p = 0.002). BMI did not significantly change (p = 0.87). Higher baseline pain and BMI correlated with greater reductions in each posttreatment. Uninsured patients had shorter treatment duration. Increasing clinic hours (4-24 h weekly) and serving 953 patients over four years demonstrated OAMP sustainability.
UNASSIGNED: OAMP implementation was feasible and sustainable. Patients with high baseline pain and BMI were more likely to improve. Noninsurance was a barrier. These results contribute to understanding OAMP outcomes in U.S. healthcare.
这项开放研究评估了一项OAMP,旨在在≤12个月的时间内进行1-5次个人或团体就诊。资格包括从2017年7月1日至2021年1月15日≥1次就诊的膝关节或髋关节骨关节炎成人。一个多学科护理团队提供:骨关节炎教育,自我管理,锻炼,体重减轻;药物管理;情绪评估,睡眠,生活质量,和饮食。诊所的利用和增长报告到2022年。患者体重指数(BMI)的结果,疼痛,和函数使用多变量一般线性模型进行分析。OAMP结果是可行性和可持续性。
■大多数患者由初级保健进行局部转诊。953名患者参加了2531次访视(平均访视2.16次,治疗持续时间187.9天)。大多数是女性(72.6%),年龄较大(62.1),白色(91.1%),并有医疗保险(95.4%)。肥胖普遍存在(84.7%BMI≥30,平均BMI40.9),平均Charlson合并症指数为1.89,功能测试低于平均水平.纵向建模显示有统计学意义,但没有临床上显着的疼痛减轻(0-10量表上的4.4-3.9,p=0.002)。BMI没有显著变化(p=0.87)。较高的基线疼痛和BMI与每次治疗后更大的降低相关。无保险患者的治疗时间较短。增加门诊时间(每周4-24小时)并在四年内服务953名患者证明了OAMP的可持续性。
■OAMP的实施是可行和可持续的。基线疼痛和BMI较高的患者更有可能改善。非保险是一个障碍。这些结果有助于理解美国医疗保健中的OAMP结果。