The following is a summary of “Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals (CONNACT) in Knee Osteoarthritis: Effectiveness-implementation Hybrid Randomized Controlled Trial of a Community-based, multidisciplinary, stratified intervention,” published in the May 2024 issue of Rheumatology by Tan et al.
This study aimed to evaluate the clinical and economic effectiveness of the Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals (CONNACT) compared to usual hospital care for adults with knee osteoarthritis (OA). Conducted as a pragmatic, single-blinded, parallel-arm randomized controlled trial (RCT), the intervention involved a community-based, multidisciplinary approach integrating exercise, education, psychological support, and nutritional guidance within a chronic care model. Participants included ambulant adults with knee OA (Kellgren-Lawrence grade > 1; Knee Injury and OA Outcome Score (KOOS4) ≤75). Primary outcomes assessed at 12 months included KOOS4 scores, with secondary measures encompassing quality of life, physical performance, symptom satisfaction, psychological well-being, dietary habits, and global perceived effect. The analysis utilized intention-to-treat principles with generalized linear models (GLM), regression modeling, and an embedded societal economic evaluation.
Results from the 110 randomized participants (55 in each group) indicated no significant between-group difference in the primary outcome measure (mean difference [MD] [95%CI]: −1.86 [−9.11, 5.38]). Both groups showed within-group improvements over 12 months, highlighting standard care’s potential benefits. However, the CONNACT group exhibited notable enhancements in dietary habits at 12 months, physical performance measures at 3 months, and global perceived effect at 6 months compared to controls. While total costs did not differ significantly between groups, the CONNACT intervention demonstrated reductions in indirect costs associated with productivity gains.
In conclusion, while CONNACT did not exhibit superiority over usual care at the 1-year mark, the study underscores the potential of community-based, multidisciplinary interventions in improving specific health outcomes and cost considerations in knee OA management. Future research should focus on understanding contextual and implementation factors to refine and optimize such integrated care models for broader clinical applicability and sustained patient benefit.
Source: sciencedirect.com/science/article/abs/pii/S1063458424011774
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