Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial

Kelli D Allen; Liubov Arbeeva; Leigh F Callahan; Katherine Combs; Tamara Godfrey; Yvonne M Golightly; Derek Hales; Carla Hill; Katie F Huffman; Amanda E Nelson; Jennifer Rees; Todd A Schwartz

doi:10.1016/j.ocarto.2025.100588

Optimizing osteoarthritis care through clinical and community partnership: Results of an exploratory trial

Osteoarthr Cartil Open. 2025 Feb 22;7(2):100588. doi: 10.1016/j.ocarto.2025.100588. eCollection 2025 Jun.

Authors

Kelli D Allen^{1

2

3}, Liubov Arbeeva¹, Leigh F Callahan^{1

2

4}, Katherine Combs⁵, Tamara Godfrey², Yvonne M Golightly⁶, Derek Hales⁷, Carla Hill^{4

8}, Katie F Huffman¹, Amanda E Nelson^{1

2}, Jennifer Rees⁹, Todd A Schwartz^{1

10}

Affiliations

¹ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, USA.
² Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
³ Center of Innovation to Accelerate North Carolina Clinical and Translational Sciences Institute, Durham VA Healthcare System, USA.
⁴ Department of Orthopaedics, University of North Carolina at Chapel Hill, USA.
⁵ YMCA of the Triangle, India.
⁶ College of Allied Health Professions, University of Nebraska Medical Center, USA.
⁷ Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, USA.
⁸ Division of Physical Therapy, Department of Health Sciences, University of North Carolina at Chapel Hill, USA.
⁹ North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, USA.
¹⁰ Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA.

Abstract

Background/purpose: To conduct an exploratory trial of a clinic-community care model (OA CARE) for managing osteoarthritis (OA).

Design: Participants (n = 60) with symptomatic knee or hip OA and overweight/obesity were randomized to OA CARE or a usual care control group (UC). Participants in the OA CARE group received a 12-month medical membership to a local YMCA, which included a 12-week weight loss program and access to exercise programming, as well as referrals to rehabilitation, nutrition, sleep-related and psychological services. Participants' primary care clinicians were given a video-based summary of OA treatment guidelines. Feasibility metrics included engagement with the weight loss program and exercise resources. Outcomes were assessed at baseline, 6-months and 12-months. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Outcomes were analyzed between groups across time points using general linear mixed models.

Results: Eighty-seven percent of the OA CARE group participated in the weight loss program, with a mean attendance of 9.2 sessions; 57 % participated in an exercise class. At 6-months, there was a statistically significant between-group difference in change in WOMAC total scores, with the OA CARE group showing greater improvement (-11.0, 95 % Confidence Interval -20.1, -1.9). At 12-months, the between-group change in WOMAC score was not statistically significant, though there was a small difference in favor of OA CARE Group (-4.9, 95 % Confidence Interval -14.1, 4.3).

Conclusion: Feasibility metrics were positive, but effects of OA CARE were modest, and a more intensive approach may be needed to enhance impacts.

Keywords: Care model; Exercise; Osteoarthritis; Weight management.

Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International (OARSI).

Abstract

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