OA: psychological intervention fails to improve pain, functional difficulty

  • JAMA Netw Open

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A positive psychological intervention did not improve pain and functional difficulty in adults (≥50 years) with osteoarthritis (OA).
  • The authors predicted there would be greater benefit to black patients because they report worse pain and prefer nontraditional treatment modalities, but this benefit failed to materialize.

Why this matters

  • A positive psychological intervention should not be a stand-alone treatment for OA.

Study design

  • Randomized, double-blind controlled trial at 2 US Veterans Affairs Medical Centers (n=360) in which black (n=180) and white (n=180) patients with OA were randomly assigned to either positive psychological intervention or a neutral control intervention for 6 weeks.
  • The positive psychological intervention was designed to build positive psychological skills (e.g., recollecting and reflecting on positive events, increasing engagement in joyful activities), whereas the neutral control focused on similarly structured neutral activities.
  • Patients were evaluated at baseline, 1 month, 3 months, and 6 months.
  • Pain and functional difficulty were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index.
  • Funding: NIH; US Veterans Affairs Administration.

Key results

  • Both pain (P<.001 and functional difficulty improved over the course of months but improvement was modest unaffected by treatment group or race>

Limitations

  • Findings from mostly male veterans may not apply to the general OA population.

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