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dc.contributor.authorHolen Gravås, Else Marit
dc.contributor.authorTveter, Anne Therese
dc.contributor.authorNossum, Randi
dc.contributor.authorEide, Ruth Else Meh
dc.contributor.authorKlokkeide, Åse
dc.contributor.authorMatre, Karin
dc.contributor.authorOlsen, Monika
dc.contributor.authorAndreassen, Øyvor
dc.contributor.authorØsterås, Nina
dc.contributor.authorHaugen, Ida Kristin
dc.contributor.authorKjeken, Ingvild
dc.description.abstractBackground: Osteoarthritis (OA) in the thumb carpometacarpal joint (CMCJ) is a prevalent disease which may lead to structural damage, severe pain and functional limitations. Evidence-based treatment recommendations state that all patients with hand OA should be offered non-pharmacological treatment. Surgery should be considered only when other treatment has proven insufficient in relieving pain. The purpose of this study was to investigate prior treatment and characteristics of patients referred to specialist health care surgical consultation due to CMCJ OA. The study includes exploring differences in pain and function between referred and non-referred hand, between men and women, and between patients with and without OA affection of other finger joints than CMCJ. Methods: Patients in this cross-sectional study reported prior non-pharmacological treatment for CMCJ OA. Patient demographics, disease and functional variables were assessed based on hand radiographs, patient-reported and observer-based outcome measures. Differences in pain and function between referred and non-referred hand, men and women, and between patients with and without additional affection of finger joints other than CMCJ, were analysed using Paired-samples T-tests, Wilcoxon Signed Rank, or Chi-Square tests. Results: One hundred and eighty patients were included. The mean age was 63 years and 79% were women. Only 21% reported having received non-pharmacological treatment before referral to surgical consultation. The results show a statistically significant worse function for referred hands, women and involvement of additional interphalangeal joints. Most patients reported no pain or mild pain in their referred hand. Conclusions: The results of this study show a non-pharmacological treatment gap in OA care. Most patients report no pain or mild pain, and that they had not received non-pharmacological treatment prior to being referred to CMCJ OA surgical consultation. The results furthermore show that CMCJ OA negatively affects all aspects of function. Strategies need to be developed to improve OA care, including educating general practitioners in evidence-based treatment recommendations and in the assessment of hand pain, and encourage the routine referral of patients with symptomatic hand OA to occupational therapy before considering surgery.en_US
dc.description.sponsorshipThis study was conducted with the financial support from The Interregional research funds (HELSEFORSK) via The Research Council of Norway, project number 243758.en_US
dc.relation.ispartofseriesBMC Musculoskeletal Disorders;20, Article number: 180 (2019)
dc.rightsNavngivelse 4.0 Internasjonal*
dc.subjectHand osteoarthritisen_US
dc.subjectOccupational therapyen_US
dc.titleNon-pharmacological treatment gap preceding surgical consultation in thumb carpometacarpal osteoarthritis- A cross-sectional studyen_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.rights.holder© The Author(s). 2019en_US
dc.source.journalBMC Musculoskeletal Disordersen_US
dc.relation.projectNorges forskningsråd: 243758en_US

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Navngivelse 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse 4.0 Internasjonal