Home-based pre-surgical psychological intervention for knee osteoarthritis (HAPPiKNEES): a feasibility randomised controlled trial

dasNair, Roshan and Mhizha-Murira, Jacqueline R. and Anderson, Pippa and Carpenter, Hannah and Clarke, Simon and Groves, Sam and Leighton, Paul and Scammell, Brigitte E. and Topcu, Gogem and Walsh, David A. and Lincoln, Nadina B. (2018) Home-based pre-surgical psychological intervention for knee osteoarthritis (HAPPiKNEES): a feasibility randomised controlled trial. Clinical Rehabilitation . 026921551875542. ISSN 1477-0873

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Abstract

Objective: To determine the feasibility of conducting a trial of a pre-surgical psychological intervention on pain, function, and mood in people with knee osteoarthritis listed for total knee arthroplasty.

Design: Multi-centre, mixed-methods feasibility randomized controlled trial of intervention plus usual care versus usual care.

Setting: Participants’ homes or hospital.

Participants: Patients with knee osteoarthritis listed for total knee arthroplasty and score >7 on either subscales of Hospital Anxiety and Depression Scale.

Intervention: Up-to 10 sessions of psychological intervention (based on cognitive behavioural therapy).

Main measures: Feasibility outcomes (recruitment and retention rates, acceptability of trial procedures and intervention, completion of outcome measures), and standardized questionnaires assessing pain, function, and mood at baseline, and four and six months post-randomisation.

Results: Of 222 people screened, 81 did not meet inclusion criteria, 64 did not wish to participate, 26 were excluded for other reasons, and 51 were randomized. A total of 30 completed 4-months outcomes and 25 completed 6-month outcomes. Modal number of intervention sessions completed was three (range 2–8). At six-month follow-up, mood, pain, and physical function scores were consistent with clinically important benefits from intervention, with effect sizes ranging from small (d = 0.005) to moderate (d = 0.74), and significant differences in physical function between intervention and usual care groups (d = 1.16). Feedback interviews suggested that participants understood the rationale for the study, found the information provided adequate, the measures comprehensive, and the intervention acceptable.

Conclusion: A definitive trial is feasible, with a total sample size of 444 people. Pain is a suitable primary outcome, but best assessed 6 and 12 months post-surgery.

Item Type: Article
Keywords: Psychological intervention, total knee arthroplasty, knee osteoarthritis, randomized controlled trial, feasibility
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Psychiatry and Applied Psychology
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rehabilitation and Ageing
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Health Sciences
Identification Number: 10.1177/0269215518755426
Depositing User: Eprints, Support
Date Deposited: 22 Jan 2018 14:34
Last Modified: 24 Feb 2018 20:24
URI: http://eprints.nottingham.ac.uk/id/eprint/49261

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