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Osteoarthritis Cartilage. 2018 Apr;26(4):485-494. doi: 10.1016/j.joca.2018.01.003. Epub 2018 Jan 9.

Telephone-based weight loss support for patients with knee osteoarthritis: a pragmatic randomised controlled trial.

Author information

1
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia; School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, 2308, Australia; Centre for Pain, Health and Lifestyle, NSW, Australia. Electronic address: kate.obrien@hnehealth.nsw.gov.au.
2
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia; School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, 2308, Australia. Electronic address: john.wiggers@hnehealth.nsw.gov.au.
3
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia; School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, 2308, Australia; Centre for Pain, Health and Lifestyle, NSW, Australia. Electronic address: amanda.j.williams@hnehealth.nsw.gov.au.
4
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia; School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, 2308, Australia. Electronic address: libby.campbell@hnehealth.nsw.gov.au.
5
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia; School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, 2308, Australia; Centre for Pain, Health and Lifestyle, NSW, Australia. Electronic address: rebecca.hodder@hnehealth.nsw.gov.au.
6
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia; School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, 2308, Australia. Electronic address: luke.wolfenden@hnehealth.nsw.gov.au.
7
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia; School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, 2308, Australia. Electronic address: serene.yoong@hnehealth.nsw.gov.au.
8
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia; School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, 2308, Australia; Centre for Pain, Health and Lifestyle, NSW, Australia. Electronic address: emma.robson@hnehealth.nsw.gov.au.
9
Outpatient Services, John Hunter Hospital, Hunter New England Local Health District, Locked Bag 1, New Lambton, NSW, 2305, Australia. Electronic address: robin.haskins@hnehealth.nsw.gov.au.
10
Centre for Pain, Health and Lifestyle, NSW, Australia; Musculoskeletal Health Sydney, University of Sydney, Lvl 10, King George V Building, Camperdown, NSW, 2050, UK. Electronic address: skamper@georgeinstitute.org.au.
11
NSW Office of Preventive Health, Liverpool Hospital, South West Sydney Local Health District, Locked Bag 7279, Liverpool, BC 1871, Australia. Electronic address: chris.rissel@sswahs.nsw.gov.au.
12
Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia; School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, 2308, Australia; Centre for Pain, Health and Lifestyle, NSW, Australia. Electronic address: christopher.m.williams@hnehealth.nsw.gov.au.

Abstract

OBJECTIVE:

To determine the effectiveness of telephone-based weight loss support in reducing the intensity of knee pain in patients with knee osteoarthritis, who are overweight or obese, compared to usual care.

DESIGN:

We conducted a parallel randomised controlled trial (RCT), embedded within a cohort multiple RCT of patients on a waiting list for outpatient orthopaedic consultation at a tertiary referral hospital in NSW, Australia. Patients with knee osteoarthritis, classified as overweight or obese [body mass index (BMI) between ≥27 kg/m2 and <40 kg/m2] were randomly allocated to receive referral to an existing non-disease specific government funded 6-month telephone-based weight management and healthy lifestyle service or usual care. The primary outcome was knee pain intensity measured using an 11-point numerical rating scale (NRS) over 6-month follow-up. A number of secondary outcomes, including self-reported weight were measured. Data analysis was by intention-to-treat according to a pre-published analysis plan.

RESULTS:

Between May 19 and June 30 2015, 120 patients were randomly assigned to the intervention (59 analysed, one post-randomisation exclusion) or usual care (60 analysed). We found no statistically significant between group differences in pain intensity [area under the curve (AUC), mean difference 5.4, 95%CI: -13.7 to 24.5, P = 0.58] or weight change at 6 months (self-reported; mean difference -0.4, 95%CI: -2.6 to 1.8, P = 0.74).

CONCLUSIONS:

Among patients with knee osteoarthritis who are overweight, telephone-based weight loss support, provided using an existing 6-month weight management and healthy lifestyle service did not reduce knee pain intensity or weight, compared with usual care.

TRIAL REGISTRATION NUMBER:

ACTRN12615000490572.

KEYWORDS:

Knee; Obesity; Osteoarthritis; Randomised controlled trial; Telephone; Weight loss

PMID:
29330101
DOI:
10.1016/j.joca.2018.01.003
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