Physical Therapy Use, Costs, and Value for Latent Classes of Good vs Poor Outcome in Patients Who Catastrophize About Their Pain Prior to Knee Arthroplasty.
To examine use, costs, and value of physical therapy (PT) among subgroups. We conducted an observational study of data from a randomized trial of a pain coping skills intervention. Good and poor outcome subgroups were determined based on Western Ontario and McMasters Universities Osteoarthritis Inde...
| Published in: | Archives of Physical Medicine & Rehabilitation Vol. 102; no. 7; pp. 1347 - 1352 |
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| Main Authors: | , , , , |
| Format: | research Journal Article |
| Published: |
W B Saunders
Jul2021
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=151121758&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 151121758 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039993 1XL jtl: Archives of Physical Medicine & Rehabilitation issn: 00039993 maglogo: N pubinfo: dt: Jul2021 vid: 102 iid: 7 pid: 1351 pub: W B Saunders place: Philadelphia, Pennsylvania artinfo: ui: 151121758 151121758 151121758 10.1016/j.apmr.2021.02.004 151121758 ppf: 1347 ppct: 5 formats: tig: atl: Physical Therapy Use, Costs, and Value for Latent Classes of Good vs Poor Outcome in Patients Who Catastrophize About Their Pain Prior to Knee Arthroplasty. aug: au: Orndahl, Christine M. Perera, Robert A. Hung, Anna Dumenci, Levent Riddle, Daniel L. affil: Department of Biostatistics, Virginia Commonwealth University, Richmond VA sug: subj: Physical Therapy Economics Health Care Costs Pain Attitude to Illness Patient Attitudes Arthroplasty, Replacement, Knee Treatment Outcomes Value-Based Health Care Human Nonexperimental Studies After Care Clinical Assessment Tools Comparative Studies Academic Medical Centers Coping Arthritis Education ab: To examine use, costs, and value of physical therapy (PT) among subgroups. We conducted an observational study of data from a randomized trial of a pain coping skills intervention. Good and poor outcome subgroups were determined based on Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) Pain and Physical Function scores. The use and costs of PT care as well as changes in WOMAC Pain and Physical Function scores over 4 time periods during a 1-year follow-up were reported. We compared the number of PT visits, total PT costs, and cost per 1-unit improvement in WOMAC scores for the 2 latent subgroups. Five academic medical centers. Patients who catastrophized about their pain prior to knee arthroplasty (N=384). Pain coping skills training, arthritis education, and usual care. The WOMAC Pain Scale was the primary outcome. The value of PT was lower and the cost of PT was higher for poor vs good outcome subgroups beginning 2 months after knee arthroplasty. For example, during the 2- to 6-month period, participants in the poor outcome subgroup incurred a PT cost of $5181.22 per 1-unit improvement in WOMAC Pain compared with $437.87 per 1-unit improvement in WOMAC Pain for the good outcome subgroup (P <.001). From the 6- to 12-month period, WOMAC scores worsened for the poor outcome subgroup, indicating no benefit from PT. Patients in 2 latent classes demonstrated clinically important differences in value of PT. Future research should identify rehabilitation-based interventions that reduce utilization and enhance effectiveness for patients at high risk for poor outcome. • Costs and value of physical therapy vary depending on whether patients experience a good vs poor outcome. • For the poor outcome subgroup, patients experienced worsening pain and function from 6-12 months postsurgery. • Identification of alternative lower cost interventions for patients at risk for poor outcome is a research priority. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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