Background/Purpose: In the UK approximately 1.75 million people age 45 and over are diagnosed with multiple, peripheral joint osteoarthritis (OA), a figure that would increase significantly with the inclusion of degenerative spinal pain. Exercise and self-management are recommended core treatment strategies for OA, but evidence is generally based on single site presentations and interventions. In clinical practice patients frequently consult with either pain in more than one joint, or re-consult over time when symptoms manifest in other joints. We developed a 6-week group programme to Facilitate Activity and Self-management in Arthritis (FASA) for people with multisite OA of the hip, knee and/or lower back. The aim of FASA was to teach an exercise programme for these joints, and provide education regarding multiple joint pain management. This qualitative study, embedded within a randomised controlled trial (RCT), presents data from a focus group analysis to determine perceived benefits and acceptability of the intervention.

Methods: Nine semi-structured, focus group interviews facilitated by a researcher independent of the RCT were conducted with patients with OA who had participated in the FASA programme, and had completed their primary end point assessment at 6 months post-intervention. The interviews were audio-recorded, transcribed and analysed using thematic analysis. A second researcher independently coded a selection of transcripts to establish accuracy of interpretation.

Results: Forty-five participants (28 female), age 53-85 years (mean=68 years) with multisite OA joint pain participated in the focus groups. Thematic analysis demonstrated that individuals reported benefits from gaining confidence and knowledge of how to self-manage pain in other joints should it manifest. They also found it beneficial to undertake exercises that took into account their multisite presentations. Gaining insight of how others coped with their pain, irrespective of site, was also considered positive; participants also talked about valuing the shared pain experience. Whilst the majority of participants valued the more general joint pain approach, three people with lower back pain found it difficult to relate to those who did not experience back pain, and expressed a preference for a specific intervention tailored to their presentation.

Conclusion: An exercise and self-management intervention for multisite OA was perceived as beneficial and acceptable to the majority of participants, who reported increased confidence and knowledge for self-management. Further consideration regarding the suitability of integrating back pain patients into these generic sessions may be necessary. Embedding a qualitative analysis into an RCT enhances our understanding of interventions and provides valuable insight from a patient perspective.

---

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/multiple-joint-osteoarthritis-patient-preferences-for-a-generic-exercise-and-self-management-programme/