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Home-based pre-surgical psychological intervention for knee osteoarthritis (HAPPiKNEES): a feasibility randomized controlled trial
Clinical Rehabilitation, Start page: 026921551875542
Swansea University Author: Pippa Anderson
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Objective: To determine the feasibility of conducting a trial of a pre-surgical psychological interventionon 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...
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Objective: To determine the feasibility of conducting a trial of a pre-surgical psychological interventionon 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 usualcare versus usual care.Setting: Participants’ homes or hospital.Participants: Patients with knee osteoarthritis listed for total knee arthroplasty and score >7 on eithersubscales 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 proceduresand 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- and 256-month outcomes. Modal number of intervention sessions completed was three (range 2–8). At sixmonthfollow-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), andsignificant differences in physical function between intervention and usual care groups (d = 1.16). Feedbackinterviews suggested that participants understood the rationale for the study, found the informationprovided 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 primaryoutcome, but best assessed 6 and 12 months post-surgery.
Psychological intervention, total knee arthroplasty, knee osteoarthritis, randomized controlled trial, feasibility
Faculty of Medicine, Health and Life Sciences