Article

OBJECTIVE: To determine the feasibility of conducting a trial of a pre-surgical
psychological intervention on 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 usual
care versus usual care. SETTING: Participants' homes or hospital. PARTICIPANTS:
Patients with knee osteoarthritis listed for total knee arthroplasty and score >7
on either subscales 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 procedures and 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-month outcomes and 25 completed 6-month outcomes. Modal number of intervention
sessions completed was three (range 2-8). At 6-month follow-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), and significant differences in physical function between intervention and
usual care groups ( d = 1.16). Feedback interviews suggested that participants
understood the rationale for the study, found the information provided 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 primary outcome, but best assessed 6 and 12 months post-surgery.

Langue : ANGLAIS