Evidence map›Paper›PMID 36205225›Full record

Trial reportArthritis care & research2023

Effectiveness of a New Service Delivery Model for Management of Knee Osteoarthritis in Primary Care: A Cluster Randomized Controlled Trial.

David J Hunter, Jocelyn L Bowden, Rana S Hinman, Thorlene Egerton, Andrew M Briggs, Stephen J Bunker, Simon D French, Marie Pirotta, Rupendra Shrestha, Deborah J Schofield and 6 more

Open access · bronzeAbstract readRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Arthritis care & research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 4 pooled it
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
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  3. Exercise for osteoarthritis of the knee.The Cochrane database of systematic reviews · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 5 institutions in 1 country.

David J HunterKolling Institute, The University of Sydney and Royal North Shore Hospital, Sydney, New South Wales, Australia.ORCID 0000-0003-3197-752X
Jocelyn L BowdenKolling Institute, The University of Sydney and Royal North Shore Hospital, Sydney, New South Wales, Australia.ORCID 0000-0002-0340-0232
Rana S HinmanThe University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0001-6368-9456
Thorlene EgertonThe University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0003-4751-7624
Andrew M BriggsCurtin University, Perth, Western Australia, Australia.ORCID 0000-0002-6736-3098
Stephen J BunkerThe University of Melbourne, Melbourne, Victoria, Australia.
Simon D FrenchMacquarie University, Sydney, New South Wales, Australia.ORCID 0000-0002-7061-7706
Marie PirottaThe University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0003-4309-6885
Rupendra ShresthaMacquarie University, Sydney, New South Wales, Australia.ORCID 0000-0001-5455-0735
Deborah J SchofieldMacquarie University, Sydney, New South Wales, Australia.ORCID 0000-0002-1658-494X
Karen SchuckKolling Institute, The University of Sydney and Royal North Shore Hospital, Sydney, New South Wales, Australia.
Nicholas A ZwarUniversity of New South Wales, Sydney, New South Wales, Australia, and Bond University, Gold Coast, Queensland, Australia.ORCID 0000-0001-6462-9121
S Sandun M SilvaThe University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-4672-981X
Gillian Z HellerThe University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-1270-1499
Kim L BennellThe University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0003-4982-5639
PARTNER Study Team
The University of Melbourne · AUThe University of Sydney · AUMacquarie University · AUBond University · AUCurtin University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effectiveness and health costs of a new primary care service delivery model (the Optimising Primary Care Management of Knee Osteoarthritis [PARTNER] model) to improve health outcomes for patients with knee osteoarthritis (OA) compared to usual care.

methodsThis study was a 2-arm, cluster, superiority, randomized controlled trial with randomization at the general practice level, undertaken in Victoria and New South Wales, Australia. We aimed to recruit 44 practices and 572 patients age ≥45 years with knee pain for >3 months. Professional development opportunities on best practice OA care were provided to intervention group general practitioners (GPs). All recruited patients had an initial GP visit to confirm knee OA diagnosis. Control patients continued usual GP care, and intervention patients were referred to a centralized care support team (CST) for 12-months. Via telehealth, the CST provided OA education and an agreed OA action plan focused on muscle strengthening, physical activity, and weight management. Primary outcomes were patient self-reported change in knee pain (Numerical Rating Scale [range 0-10; higher score = worse]) and physical function (Knee Injury and Osteoarthritis Outcome Score activities of daily living subscale [range 0-100; higher score = better] at 12 months. Health care cost outcomes included costs of medical visits and prescription medications over the 12-month period.

resultsRecruitment targets were not reached. A total of 38 practices and 217 patients were recruited. The intervention improved pain by 0.8 of 10 points (95% confidence interval [95% CI] 0.2, 1.4) and function by 6.5 of 100 points (95% CI 2.3, 10.7), more than usual care at 12 months. Total costs of medical visits and prescriptions were $3,940 (Australian) for the intervention group versus $4,161 for usual care. This difference was not statistically significant.

conclusionThe PARTNER model improved knee pain and function more than usual GP care. The magnitude of improvement is unlikely to be clinically meaningful for pain but is uncertain for function.

Indexed as

Osteoarthritis, KneeActivities of Daily LivingExercise TherapyHumansMiddle AgedPainPrimary Health CareTreatment OutcomeVictoria

Identifiers

PMID36205225
PMCPMC10952211
OpenAlexW4303517078

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.