Protocol for a quasi-experimental study to ascertain the effectiveness of using eKnee School approach to impart self-care education to patients suffering from knee osteoarthritis during COVID-19 pandemic

Meenakshi Sharma; Mandeep S Dhillon; Amarjeet Singh; Shankar Prinja; Pankaj Bahuguna; Meenu Singh; Bibek Adhya; Sandeep Negi; Nishank Verma

doi:10.4103/jehp.jehp_1758_22

Protocol for a quasi-experimental study to ascertain the effectiveness of using eKnee School approach to impart self-care education to patients suffering from knee osteoarthritis during COVID-19 pandemic

J Educ Health Promot. 2023 Sep 29:12:301. doi: 10.4103/jehp.jehp_1758_22. eCollection 2023.

Authors

Meenakshi Sharma¹, Mandeep S Dhillon², Amarjeet Singh¹, Shankar Prinja¹, Pankaj Bahuguna³, Meenu Singh⁴, Bibek Adhya⁵, Sandeep Negi⁵, Nishank Verma⁵

Affiliations

¹ Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
² Department of Orthopaedics and Physical Rehabilitation and Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
³ School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Health Economics, and Health Technology Assessment, University of Glasgow, Glasgow, UK.
⁴ Department of Advanced Pediatrics Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
⁵ Department of Physical Rehabilitation and Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Abstract

Background: Knee osteoarthritis (KOA) patients seek improvement in their quality of life by attaining independence in activities of daily living. Literature recommends nonpharmacological intervention as first-line treatment for KOA. The study aims to ascertain the effectiveness of online supervised nonpharmacological intervention sessions of virtual knee school (eKS) training among mild and moderate KOA patients in comparison to routine care during COVID-19 pandemic and assessment of cost-effectiveness of eKS against the routine care for KOA patients during COVID-19 pandemic.

Materials and methods: A quasi-experimental pre-post with control group, enrolling 50 participants each in two groups: usual/routine KOA care or usual care plus KS interventions via virtual mode. Our primary outcome measures are pain, quality of life, and incremental cost-effectiveness ratio. Secondary outcomes include performance-based tests (30-second chair test, timed up and go test, 6-minute walk test) and patient satisfaction. Intervention fidelity will be assessed with a priori checklist tailored to eKS assessing adherence, dose, quality, and user engagement in the key components. Quantitative data collection will be conducted at baseline and 6 months. Descriptive data analysis will be carried for quantitative data. For qualitative data, the thematic analysis will be performed; we propose to undertake a deterministic and probabilistic sensitivity analysis to address the issue of uncertainty in the present cost-effectiveness analysis model.

Conclusion: The management of KOA through virtual mode emphasizes the concepts of patient-as-person, family-centered, with socially interactive approach. The study will provide information on the effectiveness of nonpharmacological interventions for improving the quality of life of patients suffering from KOA through virtual knee school. Nevertheless, pitfalls in running eKS will be noted, which will help improve all aspects of online medical communications in the future.

Keywords: Knee osteoarthritis; knee school; nonpharmacological interventions.