背景:骨关节炎(OA)的主要特征是疼痛。尽管在OA的长期过程中已经证明了疼痛和功能的异质性,急性发作的更接近的决定因素仍然不太清楚。短期间歇性或暂时性暴露如何引发急性发作对有效和可持续的自我管理策略具有重要意义。
目的:本研究的主要目的是确定膝OA急性耀斑的潜在诱因。次要目标是确定其课程和后果,并描述高风险参与者的概况。
方法:我们进行了一项基于Web的病例交叉研究。这项研究旨在招募620名年龄≥40岁的社区居住成年人,居住在英国,膝盖疼痛的人,有或没有膝关节OA的记录诊断,并且没有炎性关节病的预先诊断。参与者将通过3条途径招募:(1)一般执业登记册,(2)线下社区广告,(3)在线社交媒体广告。通过使用问卷调查比较参与者自我报告的突发事件之前的时期(危险期)和研究期间他们的膝关节OA症状稳定的时期(对照期),爆发前的触发器将使用条件逻辑回归进行识别和检查。将通过监测人们的日常疼痛来检查爆发的时间,烦恼,和药物使用情况,直到参与者报告他们的突发事件结束。将使用回归模型对不同参与者和耀斑特征进行检查,以识别高风险参与者的概况。一个专门针对研究的患者咨询小组(PAG)正在提供建议,输入,以及对研究过程的所有阶段的持续支持。
结果:参与者招募于2018年7月开始,预计将持续6个月。研究结果将通过多个渠道进行传播,包括相关的国家或国际会议以及医学杂志上的同行评审出版物,通过倡导或慈善组织,例如与关节炎和社交媒体。调查结果将反馈给我们的PAG成员,研究参与者,和参与初级保健一般实践的临床医生。PAG还将在总体传播战略中发挥积极作用。
结论:这项研究将提供经验证据,以帮助患者识别常见的膝关节OA耀斑触发因素,并为医疗保健专业人员提供问题,以识别最频繁发作的患者。
■DERR1-10.2196/13428。
BACKGROUND: The cardinal feature of osteoarthritis (OA) is pain. Although heterogeneity in pain and function have been demonstrated in the long-term course of OA, the more proximate determinants of acute flare-ups remain less clear. How short-term intermittent or transient exposures trigger acute flare-ups has important implications for effective and sustainable self-management strategies.
OBJECTIVE: The primary objective of this
study is to identify potential triggers of acute flares in knee OA. Secondary objectives are to determine their course and consequences and describe high-risk participant profiles.
METHODS: We carried out a Web-based case-crossover
study. This
study aims to recruit 620 community-dwelling adults aged ≥40 years, resident in England, and who have knee pain, with or without a recorded diagnosis of knee OA, and no preexisting diagnosis of inflammatory arthropathy. Participants will be recruited via 3 routes: (1) general practice registers, (2) offline community advertisement, and (3) online social media advertisement. By using questionnaires comparing periods before participants\' self-reported flare-up episodes (hazard periods) with periods during the study when their knee OA symptoms are stable (control periods), triggers preceding flare-ups will be identified and examined using conditional logistic regression. Time-to-resolution of flare-up will be examined by monitoring people\'s daily pain, bothersomeness, and medication usage until the participant reports when their flare-up episode ends. Rates of flare-ups will be examined across different participant and flare characteristics using regression models to identify high-risk participant profiles. A
study-specific Patient Advisory Group (PAG) is providing suggestion, input, and ongoing support for all stages of the research process.
RESULTS: Participant recruitment opened in July 2018 and is anticipated to continue for 6 months. The study results will be disseminated through a number of channels, including relevant national or international conferences and peer-reviewed publication in a medical journal, via advocacy or charity organizations, such as Versus Arthritis and across social media. Findings will be fed back to members of our PAG,
study participants, and clinicians from participating primary care general practices. The PAG will also take an active role in the overall dissemination strategy.
CONCLUSIONS: This study will provide empirical evidence to help patients identify common knee OA flare triggers and provide health care professionals with questions to identify patients at most risk of frequent flare-ups.
UNASSIGNED: DERR1-10.2196/13428.