An interventional study of Rheumatologist-led care. and Occupational therapist-led care. in Osteoarthritis Both Hands, sponsored by National Resource Center for Rehabilitation in Rheumatology. Completed at 3 sites in Norway. Open to participants aged 18 Years to 100 Years. Per ClinicalTrials.gov, last updated 2024-07-12.
Sponsored by National Resource Center for Rehabilitation in Rheumatology · Not applicable, Interventional, and Health services research
The main aim in this randomized controlled trial is to improve access to safe and effective care, professional practice and cost-effective utilisation of health care resources by testing if occupational therapist-led care is as effective and safe as rheumatologist-led care for people with hand osteoarthritis.
Hand osteoarthritis is one of the most prevalent musculoskeletal conditions in an adult population, and may have large influences on an individual's function, health related quality of life, and participation in the society. In the absence of disease-modifying interventions, occupational therapy, comprising information, hand exercises, assistive devices and orthoses/splints, is considered as core treatment. In Norway, people with hand osteoarthritis are increasingly referred to consultation by a rheumatologist in specialist health care. At the same time a shortage of rheumatologists nationwide is stressing the healthcare system's capacity, and rheumatologists time should therefore primarily be allocated to patients in which early diagnosis and medical treatment are essential.
The World Health Organization recommend task-shifting as one method of strengthening and expanding the health workforce. Such models rely on other healthcare providers in expanded clinical roles, where physiotherapists, nurses or occupational therapists working in collaboration with physicians and other team members have their own patients for whom they provide health care services.
In this randomized controlled trial, we will test if a new model, where patients referred to consultation in specialist health care receive their first consultation by an occupational therapy specialist, is as safe and effective as the traditional model, where they receive their first consultation by a rheumatologist.
National Resource Center for Rehabilitation in Rheumatology is the lead sponsor of 5 studies on the registry; none are open to participants now.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Patients in the control group will receive their first consultation in specialist health care by a rheumatologist. Rheumatologist-led care comprises confirmation of diagnosis, information about hand osteoarthritis and symptom modifying medication, and, for some patients, Intra-articular injection of long-acting Corticosteroid. The rheumatologist may also refer participants to occupational therapy if needed.
Behavioral: Rheumatologist-led care.
Patients in the intervention group will receive their first consultation in specialist health care by an occupational therapy specialist. Occupational therapist-led care comprises confirmation of diagnosis, information about hand osteoarthritis and symptom modifying medication, teaching of hand exercises and ergonomic working methods, and, for some patients, provision assistive devices and orthoses/splints. The occupational therapist will refer patients to a short rheumatologist consultation if confirmation of diagnosis or intra-articular injections of long-acting Corticosteroid are needed.
Behavioral: Occupational therapist-led care.
Rheumatologist-led care comprises confirmation of diagnosis, information about hand osteoarthritis and symptom modifying medication, and, for some patients, Intra-articular injection of long-acting Corticosteroid. The rheumatologist may also refer participants to occupational therapy if needed.
Occupational therapist-led care comprises confirmation of diagnosis, information about hand osteoarthritis and symptom modifying medication, teaching of hand exercises and ergonomic working methods, and, for some patients, provision assistive devices and orthoses/splints. The occupational therapist will refer patients to a short rheumatologist consultation if confirmation of diagnosis or intra-articular injections of long-acting Corticosteroid are needed.
Number of treatment responders
Number of treatment responders will be calculated as number of OMERACT/OARSI-responders. This is a composite index that presents the results of changes after treatment in the three domains of pain, function and patient's global assessment as a single variable (responder yes/no).
Time frame: One year
Number of painful finger joints
Joint count of number of painful finger joints at each hand
Time frame: One year
Hand pain measured on a numeric rating scale
Hand pain will be measured on a numeric rating scale
Time frame: One year
Hand stiffness measured on a numeric rating scale
Hand stiffness will be measured on a numeric rating scale
Time frame: One year
Disease activity measured on a numeric rating scale
Disease activity will be measured on a numeric rating scale
Time frame: One year
Physical function measured by the Functional Index for Hand OsteoArthritis
Physical function will be measured by the Functional Index for Hand OsteoArthritis
Time frame: One year
Activity performance measured by the Measure of Activity Performance of the Hand
Activity performance will be measured by the Measure of Activity Performance of the Hand
Time frame: One year
Grip strength measured by JAMAR dynamometer
Grip strength will be measured by JAMAR dynamometer
Time frame: One year
Health related quality of life measured by EQ5D
Health related quality of life will be measured by EQ5D
Time frame: One year
Satisfaction with care measured by PASS-Opp
Satisfaction with care will be measured by PASS-Opp
Time frame: One year
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: No
This study is completed, as verified in Jun 2024. You cannot join it, but the record below documents what was studied.
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National Resource Center for Rehabilitation in Rheumatology