Opportunities - Self-management dietary and lifestyle intervention for patients with severe osteoarthritis
Self-management dietary and lifestyle intervention for patients with severe osteoarthritis
University of Calgary
Many patients with severe osteoarthritis spend long periods of time on wait lists for an assessment by an orthopedic surgeon for a hip or knee replacement. Often, osteoarthritis continues to worsen during this waiting period. Even for those whose osteoarthritis does not worsen, this is a long period to be enduring severe pain and decreased function. Research has shown that patients have an appetite for self-management; that they are eager to find ways to improve their pain and regain function.
Osteoarthritis is known to be linked to excess weight. We know that weight loss can improve the pain and disability related to osteoarthritis; even a small amount of weight loss – as little as 5%- is known to decrease pain and improve function. In Alberta, there are currently no dedicated programs to assist patients with severe osteoarthritis with weight loss. This time spent on weight lists is an ideal time to offer this type of program and is an example of prehabilitation – the optimizing of a patient’s health prior to surgery.
This opportunity is looking for patient partners with experience of osteoarthritis to join a Patient Advisory Committee (PAC) and contribute their valuable input and expertise to help inform a proposed randomized control trial. Study participants who enroll in the trial will be randomized to either receive The Osteoarthritis Optimization Program or to “usual care”.
The Osteoarthritis Optimization Program combines
- access to a computer or smartphone-based 12-week lifestyle change program, with
- periodic group sessions (one session every 3 months for 12 months).
All participants who enroll will have baseline testing done. This testing will include quality of life surveys, measurement of weight and body composition, measurement of metabolic rate, measurement of strength and bloodwork that measures metabolic health.
The emphasis of the program is on adopting a dietary approach which reduces carbohydrate consumption. Common sources of carbohydrates include the following: breads, grains, pasta, cereals, sugary desserts, common snack foods, sugary drinks and starchy vegetables. Participants in the study will be asked to greatly reduce or even eliminate the foods on this list.
Potential benefits for study participants are improved health and quality of life. The study is not large enough to demonstrate the following however anecdotally, some patients who have adopted this dietary approach do show improvement in pain and function, improved health prior to surgery, or even the ability to postpone surgery due to improvement in osteoarthritis symptoms.
Roles and Responsibilities
We are looking for patient partners with experience of osteoarthritis, either their own or as family members or caregiver, to form the Patient Advisory Committee (PAC). Involving patients, as partners, in the study design, conduct, interpretation of results and dissemination activities will increase the relevance and utility of the results and overall impact of this study. The patient partners will be expected to contribute to discussions on appropriateness of the study, participant recruitment suggestions and strategies, identifying and resolving barriers to enrolling and continuing with the study as well as dissemination strategies.
The proposed study is currently seeking funding.
The anticipated start date is Spring 2020 and the study will run for 2 years. All meetings will occur via tele/videoconference.
It is anticipated there will be 5 Patient Advisory Committee (PAC) meetings in total. These initial meetings will be weekly, about 30 minutes each until grant application is completed. If the grant application is successful, there will be monthly updates with the research team.
Patient partners will be provided with an honorarium for their valued experience, expertise and participation. If the study goes on to receive funding, compensation for patient partners will be built into the budget.
Project Team Contact
Dr Miriam Berchuk