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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.

Publication ,  Journal Article
Orndahl, CM; Perera, RA; Hung, A; Dumenci, L; Riddle, DL
Published in: Arch Phys Med Rehabil
July 2021

OBJECTIVE: To examine use, costs, and value of physical therapy (PT) among subgroups. DESIGN: 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. SETTING: Five academic medical centers. PARTICIPANTS: Patients who catastrophized about their pain prior to knee arthroplasty (N=384). INTERVENTIONS: Pain coping skills training, arthritis education, and usual care. MAIN OUTCOME MEASURES: The WOMAC Pain Scale was the primary outcome. RESULTS: 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. CONCLUSIONS: 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.

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Published In

Arch Phys Med Rehabil

DOI

EISSN

1532-821X

Publication Date

July 2021

Volume

102

Issue

7

Start / End Page

1347 / 1351

Location

United States

Related Subject Headings

  • Rehabilitation
  • Physical Therapy Modalities
  • Pain Measurement
  • Middle Aged
  • Male
  • Humans
  • Female
  • Catastrophization
  • Arthroplasty, Replacement, Knee
  • Aged
 

Citation

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Chicago
ICMJE
MLA
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Orndahl, C. M., Perera, R. A., Hung, A., Dumenci, L., & Riddle, D. L. (2021). 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. Arch Phys Med Rehabil, 102(7), 1347–1351. https://doi.org/10.1016/j.apmr.2021.02.004
Orndahl, Christine M., Robert A. Perera, Anna Hung, Levent Dumenci, and Daniel L. Riddle. “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.Arch Phys Med Rehabil 102, no. 7 (July 2021): 1347–51. https://doi.org/10.1016/j.apmr.2021.02.004.
Orndahl, Christine M., et al. “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.Arch Phys Med Rehabil, vol. 102, no. 7, July 2021, pp. 1347–51. Pubmed, doi:10.1016/j.apmr.2021.02.004.
Orndahl CM, Perera RA, Hung A, Dumenci L, Riddle DL. 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. Arch Phys Med Rehabil. 2021 Jul;102(7):1347–1351.
Journal cover image

Published In

Arch Phys Med Rehabil

DOI

EISSN

1532-821X

Publication Date

July 2021

Volume

102

Issue

7

Start / End Page

1347 / 1351

Location

United States

Related Subject Headings

  • Rehabilitation
  • Physical Therapy Modalities
  • Pain Measurement
  • Middle Aged
  • Male
  • Humans
  • Female
  • Catastrophization
  • Arthroplasty, Replacement, Knee
  • Aged