N/A
Completed N=69
A Cost-efficiency Analysis of Primary Assessors for Patients With Knee Pain in Primary Care
Osteoarthritis, Knee
Source: ClinicalTrials.gov NCT03822533 ↗
Enrolled (actual)
69
Serious AEs
0.0%
Results posted
May 2024
Primary outcomePrimary: Mean Difference in Quality Adjusted Life Years (QALY) — 0.74; 0.73 score on a scale — p=0.69
Summary
Background: Almost half of the Swedish population are overweight or obese. This will probably affect the incidence of osteoarthritis since overweight is a strong risk factor. Osteoarthritis consultations is expected to increase with 30-50% within the next 20 years. Today, in Swedish primary care, both physicians and physiotherapists are primary assessors for patients with suspected knee osteoarthritis. A task shifting with physiotherapists as the only primary assessor could increase the access rate to physicians in primary care for patients with more severe disorders. Yet, it is unclear what effects these different healthcare processes have and the costs of it.
Purpose: The overall purpose of this study is to perform an economic evaluation of two healthcare processes, where a healthcare process initiated by a physiotherapist is compared with when it is initiated with a physician for patients with suspected knee osteoarthritis.
Methods: 100 patients will be randomized either to a physiotherapists or to a physician for first assessment, diagnosis and treatment. Measurements of health-related quality of life and costs for visits to physiotherapists, physician or other healthcare provider, drug prescriptions and sick-leave will be collected. A cost-effectiveness analysis will be conducted, presenting incremental cost-effectiveness ratio (ICER) and a non-parametric bootstrapping will be conducted to demonstrate the uncertainties surrounding the ICER.
Expected results: It is expected that this randomized controlled study will show the effects on quality adjusted life years, cost-efficiency and cost-utility of two different primary assessors for patients with suspected knee osteoarthritis consulting primary care. The results could clarify which profession that is most appropriate to be the primary assessor for patients with suspected knee osteoarthritis in primary care.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Mean Difference in Quality Adjusted Life Years (QALY) |
0.74; 0.73 | 0.69 |
| PRIMARY Mean Difference in Total Costs (Societal Perspective) |
633; 996 | 0.17 |
| PRIMARY Mean Difference in Total Costs (Health Care Perspective) |
515; 748 | 0.23 |
| PRIMARY Incremental Cost-effectiveness Ratio (ICER) - Societal Perspective |
24266 | — |
| PRIMARY Incremental Cost-effectiveness Ratio (ICER) - Health Care Perspective |
15533 | — |
| SECONDARY Costs for Physiotherapy Visits |
380; 332 | 0.72 |
| SECONDARY Costs for Physician Visits |
39; 217 | <0.01 sig |
| SECONDARY Costs for Referrals to Radiography |
7.9; 32 | 0.01 sig |
| SECONDARY Costs for Referrals to Orthopedic Surgeon |
22; 33 | 0.62 |
| SECONDARY Costs for Collected Prescribed Drugs |
7.8; 6.6 | 0.87 |
| SECONDARY Costs for Productivity Loss |
111; 365 | 0.27 |
| SECONDARY Costs for Unpaid Work Compensation |
125; 123 | 0.96 |
Eligibility Criteria
Inclusion Criteria
- Knee pain most of the days the last month
- Over 38 years old
- Crepitus on active motion
- Morning stiffness less than 30 minutes
Exclusion Criteria
- Not been diagnosed for current knee pain
- Non-traumatic cause due to current knee pain
- No other rheumatic, severe somatic or psychological diseases that can affect the outcome measures.
- Not pregnant
- Does not know enough Swedish to answer questionnaires.
Data sourced from ClinicalTrials.gov (NCT03822533). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.