Ottawa panel evidence-based clinical practice guidelines for patient education programmes in the management of osteoarthritis

Abstract

Objective: The purpose of this study was to develop guidelines and recommendations on patient education programmes of any type, targeted specially to individuals with OA and which were designed to improve the clinical effectiveness of managing OA. Methods: The Ottawa Methods Group contacted specialized organizations that focus on management for individuals diagnosed with OA to nominate nine experienced clinicians specializing in various fields –rheumatology, physiatry, medicine, occupational therapy, physical therapy – and a patient with OA. The EBCPGs in this report were created based on the Appraisal of Guidelines Research and Evaluation (AGREE) criteria. The Ottawa Panel graded the recommendations according to levels (I for randomized controlled trials [RCTs], II for non-randomized studies) and strength of evidence (A, B, C, C+, D, D+, or D–). Results: Using a systematic approach to our literature search, a total of over 1000 articles was found on the efficacy of patient education for OA, and 57 articles were recognized as potentially relevant. Based on the inclusion and exclusion selection criteria, 20 studies were ultimately included. Results from the Jadad scale illustrated that seven of the 20 studies included were considered of high methodological quality (≥ 3). The remaining studies received low scores, therefore they were categorized as poor methodological quality trials. Conclusion: This review of the studies to date seems to indicate the potential of patient education for OA to positively affect pain, at least in the short-term, and exercise compliance in the longer term. While the programmes reviewed varied widely in the focus and approach of education, a number of promising ‘effective ingredients’ seem to be suggested by this review. The Ottawa Panel recommendations are in concordances with other clinical practice guidelines related to the efficacy of patient education for the management of OA, especially to improve pain, physical activity level, self-efficacy and quality of life.