Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial

Background/Purpose: To conduct an exploratory trial of a clinic-community care model (OA CARE) for managing osteoarthritis (OA). Design: Participants (n ​= ​60) with symptomatic knee or hip OA and overweight/obesity were randomized to OA CARE or a usual care control group (UC). Participants in the O...

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Main Authors: Kelli D. Allen, Liubov Arbeeva, Leigh F. Callahan, Katherine Combs, Tamara Godfrey, Yvonne M. Golightly, Derek Hales, Carla Hill, Katie F. Huffman, Amanda E. Nelson, Jennifer Rees, Todd A. Schwartz
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Osteoarthritis and Cartilage Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S266591312500024X
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author Kelli D. Allen
Liubov Arbeeva
Leigh F. Callahan
Katherine Combs
Tamara Godfrey
Yvonne M. Golightly
Derek Hales
Carla Hill
Katie F. Huffman
Amanda E. Nelson
Jennifer Rees
Todd A. Schwartz
author_facet Kelli D. Allen
Liubov Arbeeva
Leigh F. Callahan
Katherine Combs
Tamara Godfrey
Yvonne M. Golightly
Derek Hales
Carla Hill
Katie F. Huffman
Amanda E. Nelson
Jennifer Rees
Todd A. Schwartz
author_sort Kelli D. Allen
collection DOAJ
description Background/Purpose: To conduct an exploratory trial of a clinic-community care model (OA CARE) for managing osteoarthritis (OA). Design: Participants (n ​= ​60) with symptomatic knee or hip OA and overweight/obesity were randomized to OA CARE or a usual care control group (UC). Participants in the OA CARE group received a 12-month medical membership to a local YMCA, which included a 12-week weight loss program and access to exercise programming, as well as referrals to rehabilitation, nutrition, sleep-related and psychological services. Participants’ primary care clinicians were given a video-based summary of OA treatment guidelines. Feasibility metrics included engagement with the weight loss program and exercise resources. Outcomes were assessed at baseline, 6-months and 12-months. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Outcomes were analyzed between groups across time points using general linear mixed models. Results: Eighty-seven percent of the OA CARE group participated in the weight loss program, with a mean attendance of 9.2 sessions; 57 ​% participated in an exercise class. At 6-months, there was a statistically significant between-group difference in change in WOMAC total scores, with the OA CARE group showing greater improvement (−11.0, 95 ​% Confidence Interval −20.1, −1.9). At 12-months, the between-group change in WOMAC score was not statistically significant, though there was a small difference in favor of OA CARE Group (−4.9, 95 ​% Confidence Interval −14.1, 4.3). Conclusion: Feasibility metrics were positive, but effects of OA CARE were modest, and a more intensive approach may be needed to enhance impacts.
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spelling doaj-art-d2f307cfeb4e49dba1cba5becc7279da2025-08-20T03:13:33ZengElsevierOsteoarthritis and Cartilage Open2665-91312025-06-017210058810.1016/j.ocarto.2025.100588Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trialKelli D. Allen0Liubov Arbeeva1Leigh F. Callahan2Katherine Combs3Tamara Godfrey4Yvonne M. Golightly5Derek Hales6Carla Hill7Katie F. Huffman8Amanda E. Nelson9Jennifer Rees10Todd A. Schwartz11Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Center of Innovation to Accelerate North Carolina Clinical and Translational Sciences Institute, Durham VA Healthcare System, USA; Corresponding author. Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, USA.Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, USAThurston Arthritis Research Center, University of North Carolina at Chapel Hill, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Orthopaedics, University of North Carolina at Chapel Hill, USAYMCA of the Triangle, IndiaDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USACollege of Allied Health Professions, University of Nebraska Medical Center, USACenter for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, USADepartment of Orthopaedics, University of North Carolina at Chapel Hill, USA; Division of Physical Therapy, Department of Health Sciences, University of North Carolina at Chapel Hill, USAThurston Arthritis Research Center, University of North Carolina at Chapel Hill, USAThurston Arthritis Research Center, University of North Carolina at Chapel Hill, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USANorth Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, USAThurston Arthritis Research Center, University of North Carolina at Chapel Hill, USA; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USABackground/Purpose: To conduct an exploratory trial of a clinic-community care model (OA CARE) for managing osteoarthritis (OA). Design: Participants (n ​= ​60) with symptomatic knee or hip OA and overweight/obesity were randomized to OA CARE or a usual care control group (UC). Participants in the OA CARE group received a 12-month medical membership to a local YMCA, which included a 12-week weight loss program and access to exercise programming, as well as referrals to rehabilitation, nutrition, sleep-related and psychological services. Participants’ primary care clinicians were given a video-based summary of OA treatment guidelines. Feasibility metrics included engagement with the weight loss program and exercise resources. Outcomes were assessed at baseline, 6-months and 12-months. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Outcomes were analyzed between groups across time points using general linear mixed models. Results: Eighty-seven percent of the OA CARE group participated in the weight loss program, with a mean attendance of 9.2 sessions; 57 ​% participated in an exercise class. At 6-months, there was a statistically significant between-group difference in change in WOMAC total scores, with the OA CARE group showing greater improvement (−11.0, 95 ​% Confidence Interval −20.1, −1.9). At 12-months, the between-group change in WOMAC score was not statistically significant, though there was a small difference in favor of OA CARE Group (−4.9, 95 ​% Confidence Interval −14.1, 4.3). Conclusion: Feasibility metrics were positive, but effects of OA CARE were modest, and a more intensive approach may be needed to enhance impacts.http://www.sciencedirect.com/science/article/pii/S266591312500024XOsteoarthritisExerciseWeight managementCare model
spellingShingle Kelli D. Allen
Liubov Arbeeva
Leigh F. Callahan
Katherine Combs
Tamara Godfrey
Yvonne M. Golightly
Derek Hales
Carla Hill
Katie F. Huffman
Amanda E. Nelson
Jennifer Rees
Todd A. Schwartz
Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial
Osteoarthritis and Cartilage Open
Osteoarthritis
Exercise
Weight management
Care model
title Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial
title_full Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial
title_fullStr Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial
title_full_unstemmed Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial
title_short Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial
title_sort optimizing osteoarthritis care through clinical and community partnership results of an exploratory trial
topic Osteoarthritis
Exercise
Weight management
Care model
url http://www.sciencedirect.com/science/article/pii/S266591312500024X
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