Patients With Higher Treatment Outcome Expectations Are More Satisfied With the Results of Nonoperative Treatment for Thumb Base Osteoarthritis: A Cohort Study

Lisa Hoogendam*, Mark J.W. van der Oest, the Hand-Wrist Study Group

*Corresponding author for this work

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Objective: To investigate how satisfaction with treatment outcome is associated with patient mindset and Michigan Hand Outcome Questionnaire (MHQ) scores at baseline and 3 months in patients receiving nonoperative treatment for first carpometacarpal joint (CMC-1) osteoarthritis (OA). Design: Cohort study Setting: A total of 20 outpatient locations of a clinic for hand surgery and hand therapy in the Netherlands. Participants: Patients (N=308) receiving nonoperative treatment for CMC-1 OA, including exercise therapy, an orthosis, or both, between September 2017 and February 2019. Interventions: Nonoperative treatment (ie, exercise therapy, an orthosis, or both) Main Outcome Measures: Satisfaction with treatment outcomes was measured after 3 months of treatment. We measured total MHQ score at baseline and at 3 months. As baseline mindset factors, patients completed questionnaires on treatment outcome expectations, illness perceptions, pain catastrophizing, and psychological distress. We used multivariable logistic regression analysis and mediation analysis to identify factors associated with satisfaction with treatment outcomes. Results: More positive pretreatment outcome expectations were associated with a higher probability of being satisfied with treatment outcomes at 3 months (odds ratio, 1.15; 95% confidence interval, 1.07-1.25). Only a relatively small part (33%) of this association was because of a higher total MHQ score at 3 months. None of the other mindset and hand function variables at baseline were associated with satisfaction with treatment outcomes. Conclusions: This study demonstrates that patients with higher pretreatment outcome expectations are more likely to be satisfied with treatment outcomes after 3 months of nonoperative treatment for CMC-1 OA. This association could only partially be explained by a better functional outcome at 3 months for patients who were satisfied. Health care providers treating patients nonoperatively for CMC-1 OA should be aware of the importance of expectations and may take this into account in pretreatment counseling.

Original languageEnglish
Pages (from-to)1533-1540
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Issue number8
Publication statusPublished - Aug 2021

Bibliographical note

Funding Information:
The collaborators of the Hand-Wrist Study Group are R.A.M. Blomme, B.J.R. Sluijter, D.J.J.C. van der Avoort, A. Kroeze, J. Smit, J. Debeij, E.T. Walbeehm, G.M. van Couwelaar, G.M. Vermeulen, J.P. de Schipper, J.F.M. Temming, J.H. van Uchelen, H.L. de Boer, K.P. de Haas, K. Harmsen, O.T. Z?phel, R. Feitz, J.S. Souer, R. Koch, S.E.R. Hovius, T.M. Moojen, X. Smit, R. van Huis, P.Y. Pennehouat, K. Schoneveld, Y.E. van Kooij, R.M. Wouters, P. Zagt, F.J. van Ewijk, J.J. Veltkamp, A. Fink, W.A. de Ridder, H.P. Slijper, R.W. Selles, J.T. Porsius, J. Tsehaie, R. Poelstra, M.C. Jansen, M.J.W. van der Oest, P.O. Sun, L. Hoogendam, J.S. Teunissen, Jak Dekker, M.L. Jansen-Landheer, and M.H.P. ter Stege. Disclosures: Dr Wouters received a grant from ZonMW during this study.

Publisher Copyright:
© 2021 American Congress of Rehabilitation Medicine


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