Treatment of patients with hand osteoarthritis : outcome measures, patient satisfaction, and economic evaluation

Marks, M. (2014)

Doctoral Thesis

The aim of this thesis was to investigate the limitations in daily life, outcome measures, clinical outcomes with the emphasis on patient satisfaction, and economic aspects of the treatment of hand osteoarthritis (OA). Patients with hand OA report severe restrictions in daily life, in particular in opening food packaging. We defined guidelines for the industry on the production of easy-to-open food packaging to make life easier for patients in the future. For evaluating the outcome of an intervention, numerous patient-reported outcome measures are used at present with questionable measurement properties. We could show that the Michigan Hand Outcomes Questionnaire demonstrates good measurement properties in patients with trapeziometacarpal (TMC) OA. Many variables determine patient satisfaction with treatment; expectations being fulfilled, relief of pain or symptoms, and the restoration of hand function are the most important determinants. Evaluation of the outcomes of conservative and surgical management in patients with TMC OA showed that surgery leads to significantly improved hand function after one year, while conservative treatment is most effective in the first 6 months. From an economic point of view, surgery is associated with considerably higher costs than conservative treatment, with respect to both healthcare costs and loss of productivity.

• Satisfaction
• Economics
• Outcome measures
• Thumb
• Carpometacarpal joint
• Hand
• Osteoarthritis

• All authors: Marks, M.
• Supervisor: Nelissen, R.G.H.H.; Vliet Vlieland, T.P.M.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2014-09-11
• ISBN (print): 9789461824370