NMA: Nonprescription Medicines Academy

Pharmacy-Based Intervention Addresses Gaps in Osteoarthritis Patient Care

October 17th, 2012

A multidisciplinary, pharmacy-based intervention to improve health outcomes for patients with undiagnosed knee osteoarthritis produced significant increases in more than half of the Arthritis Foundation quality indicators, according to an early release article accepted for publication in Arthritis Care & Research.

The Pharmacist-Initiated Intervention Trial in Osteoarthritis (PhIT-OA) was a cluster, randomized, controlled trial conducted in 32 pharmacies in Canada. Patients were eligible for PhIT-OA if they:

  • Were at least 50 years of age and overweight (defined as body mass index ≥ 25).
  • Experienced pain, aching, or stiffness in or around one or both knees on most days of the last month.
  • Reported difficulty in activities attributed to knee pain.
  • Had not participated actively in a formal exercise program within the past 6 months.

In the 14 intervention pharmacies, a total of 73 participants met one-on-one with pharmacists who provided education about knee osteoarthritis, medication review and counseling (with attention to concordance with current osteoarthritis treatment guidelines), and referral to a physiotherapist-guided exercise program, in consultation with the patient’s primary care provider. The 66 participants in the 18 usual care pharmacies received an educational pamphlet on knee OA created by the Arthritis Society. The primary outcome was the pass rate on the Arthritis Foundation's quality indicators for osteoarthritis after 6 months. Secondary outcomes included function, pain, and quality of life, measured by a number of instruments including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Lower Extremity Function Scale (LEFS), the Paper Adaptive Test-5D (PAT-5D) and Health Utilities Index Mark 3 (HUI3) at baseline, 3 months, and 6 months.

The overall quality indicator pass rate was significantly higher in the intervention group than in the usual care group (difference of 45.2%; 95% CI, 34.5–55.9; p <0.0001). Significant improvements also were observed for the intervention group vs the usual care group in the WOMAC global, pain, and function scores at 3 months and 6 months (all p <0.01); PAT-5D daily activity scores at 3 months and 6 months (both p <0.05); PAT-5D pain scores at 6 months (p = 0.05); HUI3 single-attribute pain score at 3 months and 6 months (all p <0.05); and the LEFS scores at 6 months (p <0.05).

Arthritis Care Res (Hoboken). 2012 Aug 28. [Epub ahead of print]