Table 5.1Symptoms: pain

Pain outcomeReferenceInterventionAssessment timeOutcome/effect size
Knee
Pain severity (VAS, change from baseline)1 implementation study (De Jong et al. 2004) (N=204)Knee programme (pre-test vs post-test)6 weeks, end of intervention−5.4, p=0.002
Favours intervention
Pain tolerance (VAS, change from baseline)1 implementation study (De Jong et al. 2004) (N=204)Knee programme (pre-test vs post-test)6 weeks, end of intervention−3.9, p=0.034
Favours intervention
IRGL pain scale (scale 5–25, change from baseline)1 implementation study (De Jong et al. 2004) (N=204)Knee programme (pre-test vs post-test)6 weeks, end of intervention−0.4, p=0.015
Favours intervention
WOMAC pain1 RCT (Nunez et al. 2006) (N=100)Therapeutic education and functional readaptation programme (TEFR) + conventional (pharmacologic) treatment vs control (waiting list) + pharmacologic treatment9 months, 6 months post-interventionNS
WOMAC pain1 RCT (Victor and Triggs 2005) (N=193)Education programme (nurse-led) vs control (waiting list) group1 month (end of intervention) and at 1 year (11 months post-intervention)NS
Hip
Pain severity (VAS, change from baseline)1 implementation study (De Jong et al. 2004) (N=169)Hip programme (pre-test vs post-test)9 weeks, end of intervention−4.7, p=0.007
Favours intervention
Pain tolerance (VAS, change from baseline)1 implementation study (De Jong et al. 2004) (N=169)Hip programme (pre-test vs post-test)9 weeks, end of intervention−4.9, p=0.004
Favours intervention
IRGL pain scale (scale 5–25, change from baseline)1 implementation study (De Jong et al. 2004) (N=169)Hip programme (pre-test vs post-test)9 weeks, end of intervention−0.4, p=0.032
Favours intervention
Knee and/or hip
WOMAC Pain1 RCT (Buszewicz et al. 2006) (N=812)Self-management programme + education booklet vs education booklet alone4 months and 12 months post-interventionNS
Unspecified site
Pain (weighted average standardised gain difference)1 MA (Superio-Cabuslay et al. 1996) (9 RCTs), N=9 RCTsPatient education vs controlStudy duration between 1 to 42 monthsEffect size: 0.16, 95% CI −0.69 to 1.02
No p–values given
Pain (Pooled estimate)1 MA (Chodosh et al. 2005) (14 RCTs)Self-management programmes vs control groups (mostly usual care or programme control)4 to 6 months follow-upEffect size: −0.06, 95% CI −0.10 to −0.02, p<0.05.
Favours intervention
Effect size equivalent to improvement of <2mm on VAS pain scale
Knee pain (VAS)1 RCT (Heuts 2005) (N=297)Self-management programme vs usual care3 months post-intervention and 21 months post-interventionMean improvement 3 months: 0.67 (self-management) and 0.01 (usual care), p=0.023
21 months: 0.39 (self-management) and −0.48 (usual care), p=0.004
Hip pain (VAS)1 RCT (Heuts 2005) (N=297)Self-management programme vs usual care3 months post-intervention and 21 months post-interventionNS

From: 5, Education and self-management

Cover of Osteoarthritis
Osteoarthritis: National Clinical Guideline for Care and Management in Adults.
NICE Clinical Guidelines, No. 59.
National Collaborating Centre for Chronic Conditions (UK).
Copyright © 2008, Royal College of Physicians of London.

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