Experiences of living with hip osteoarthritis and of receiving advice, education and ultrasound‐guided intra‐articular hip injection in the hip injection trial. A qualitative study
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Published:2023-10-31
Issue:4
Volume:21
Page:1601-1611
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ISSN:1478-2189
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Container-title:Musculoskeletal Care
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language:en
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Short-container-title:Musculoskeletal Care
Author:
Holden Melanie Ann1ORCID,
Hawarden Ashley12,
Paskins Zoe12,
Roddy Edward12,
Mallen Christian D.1,
Liddle Jennifer3,
Bourton Amy4,
Jinks Clare1,
Affiliation:
1. Primary Care Centre Versus Arthritis School of Medicine Keele University Keele UK
2. Haywood Academic Rheumatology Centre Midlands Partnership NHS Foundation Trust Stoke‐on‐Trent UK
3. Population Health Sciences Institute Newcastle University Newcastle Upon Tyne UK
4. Centre for Academic Primary Care Lifespan and Population Health School of Medicine University of Nottingham Nottingham UK
Abstract
AbstractObjectivesThe Hip Injection Trial (HIT) compared the effectiveness of adding a single ultrasound‐guided intra‐articular injection of either corticosteroid and local anaesthetic or local anaesthetic alone to advice and education among people with hip osteoarthritis (OA). This nested qualitative study explored participants' experiences of living with hip OA and of the trial treatment they received.MethodSemi‐structured telephone interviews were undertaken with a purposeful sample of trial participants after a 2‐month trial follow‐up. Interviewers were blinded to which injection participants had received. Thematic analysis using constant comparison was undertaken prior to knowing the trial results.Results34 trial participants were interviewed across all arms. OA causes pain, physical limitations, difficulties at work, lowered mood, and disrupted sleep. Those who received advice and education alone felt that they had not received ‘treatment’ and described little/no benefit. Participants in both injection groups described marked improvements in pain, physical function, and other aspects of life (e.g., sleep, confidence). The perceived magnitude of benefit appeared greater among those who received the corticosteroid injection; however, the length of benefit varied in both injection groups. There was uncertainty about the longer‐term benefits of injection and repeated injections.ConclusionHip OA is highly burdensome. Participants perceived little/no benefit from advice and education alone but reported marked improvements when combined with either injection. However, the magnitude of benefit was greater among those who received corticosteroid. The varying duration of response to injection and uncertainty regarding longer‐term benefits of injection and repeated injections suggests that these areas are important for future research.Trial registration: EudraCT 2014‐003412‐37; ISRCTN50550256.
Funder
National Institute for Health and Care Research
Subject
Nursing (miscellaneous),Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine,Chiropractics,Rheumatology