Skip to main content

Research Repository

Advanced Search

Do Patients With Intersectional Disadvantage Have Poorer Outcomes From Osteoarthritis Management Programs? A Tapered Balancing Study of Patient Outcomes From the Good Life With Osteoarthritis in Denmark Program

Peat, George; Yu, Dahai; Grønne, Dorte T.; Roos, Ewa M.; Skou, Soren T.; Marshall, Michelle

Do Patients With Intersectional Disadvantage Have Poorer Outcomes From Osteoarthritis Management Programs? A Tapered Balancing Study of Patient Outcomes From the Good Life With Osteoarthritis in Denmark Program Thumbnail


Authors

George Peat

Dorte T. Grønne

Ewa M. Roos

Soren T. Skou



Abstract

OBJECTIVES: To investigate whether adults with potential multiple social disadvantage have poorer outcomes following osteoarthritis management programme (OAMP) attendance and if so, what might determine this. METHODS: Among consecutive knee OA attenders on the GLA:D® OAMP in Denmark we defined a group with potential 'intersectional disadvantage' based on self-reported educational attainment, country of birth, and citizenship. Their outcomes were compared with GLA:D® participants who were native Danish citizens with higher educational attainment. Outcomes were pain intensity, KOOS Quality of Life, and EQ-5D-5L at 3 and 12 months. After data pre-processing, we used entropy balancing to sequentially control for differences between the groups in baseline covariates. Mean between-group differences in outcomes were estimated by weighted linear regression. RESULTS: Of 18,448 eligible participants, 250 (1.4%) were non-native/foreign citizens with lower education. After balancing for differences in baseline score, administrative, and demographic characteristics, they had poorer outcomes than higher educated native Danish citizens on pain intensity and EQ-5D-5L at both follow-up points (e.g. between-group mean differences (95%CI) in pain VAS (0-100) at 3 and 12 months: 3.4 (-0.5, 7.3) and 6.2 (1.7, 10.7) respectively). Differences in KOOS QOL were smaller or absent. Balancing for differences on baseline score, comorbidity, self-efficacy, and depression had the greatest effect on reducing observed outcome inequalities. CONCLUSION: Outcome inequalities widened following OAMP attendance, particularly at longer-term follow-up but the magnitude of differences was generally modest and inconsistent across outcome measures. Tailoring content to reduce outcome inequalities may be indicated but improving access appears the greater priority.

Citation

Peat, G., Yu, D., Grønne, D. T., Roos, E. M., Skou, S. T., & Marshall, M. (2023). Do Patients With Intersectional Disadvantage Have Poorer Outcomes From Osteoarthritis Management Programs? A Tapered Balancing Study of Patient Outcomes From the Good Life With Osteoarthritis in Denmark Program. Arthritis Care and Research, 75(1), 136-144. https://doi.org/10.1002/acr.24987

Journal Article Type Article
Acceptance Date Jul 26, 2022
Online Publication Date Sep 10, 2022
Publication Date 2023-01
Publicly Available Date May 30, 2023
Journal Arthritis Care & Research
Print ISSN 2151-464X
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 75
Issue 1
Pages 136-144
DOI https://doi.org/10.1002/acr.24987
Keywords Rheumatology
Publisher URL https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.24987

Files







You might also like



Downloadable Citations