Measuring important activities for patients with knee osteoarthritis: a cross-sectional study

Abstract

Background/Aims Some patient-reported outcome measures ask questions about fixed (ie standardised) activities. Other patient-reported outcome measures ask questions about activities that patients choose or generate. However, patients' appraisals of the importance of fixed and generated activities have not been directly compared and little is known about the construct of activity importance. The aim of this study was to compare patients' importance ratings for fixed and generated activities. It also examined relationships among patients' ratings of activity importance, pain and physical function. Methods Within a prospective cross-sectional design, 60 participants with knee osteoarthritis completed the Brief Pain Inventory, Western Ontario and McMaster Universities Osteoarthritis Index, as well as the McMaster Toronto Arthritis Patient Preference Questionnaire and a Patient-Reported Outcomes Measurement Information System physical function short form, which were modified to measure the importance of generated or fixed activities respectively. Results Participants rated generated activities as more important than fixed activities (P<0.01). They also gave higher importance ratings for fixed activities that they performed than fixed activities that they did not perform (P<0.01). The importance of the generated activities correlated with the Brief Pain Inventory (P<0.05) and Western Ontario and McMaster Universities Osteoarthritis Index (P<0.01), but the fixed activities' importance did not. Participants preferred to rate generated activities more than fixed activities (63.8%) and believed that their ratings of generated activities would better inform physicians than fixed activities (55.0%). Conclusions The results from this study identified benefits of including generated activities within patient-reported outcome measures and clarified the construct of activity importance for patients with musculoskeletal pain. Implications for practice Allied health professionals may maximise activity importance for their patients by focusing on patient-generated activities. However, the best instructions for collecting patient-generated activities are unknown.