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#2-27E. Cost-Effective Care for Hip OA: The CHAIN Cycling Intervention (Lancet Rheumatol, 2025)
2025年11月3日 05:00·16分3秒
How can clinicians provide cost-effective, easily accessible exercise therapy for patients suffering from hip osteoarthritis (OA), a leading cause of chronic disability? The CLEAT trial, a pragmatic randomized controlled trial, addressed this by comparing the group-based Cycling against Hip Pain (CHAIN) program, which combines static cycling and education, with usual one-to-one physiotherapy care for hip OA patients in the UK National Health Service (NHS) setting. The study's primary outcome was the Hip Disability and Osteoarthritis Outcome Score (HOOS) ADL subscale at 10 weeks post-treatment. The research revealed that the CHAIN intervention resulted in a statistically significant improvement in patient-reported function compared to usual physiotherapy care (adjusted mean difference 6.9, p=0.0023). Crucially, the intervention proved highly cost-effective, reporting a cost of just £4,092 per quality-adjusted life year (QALY) gained, significantly below the standard NICE threshold. However, note that while statistically significant, this functional difference did not meet the pre-defined minimum clinically important difference of 7.4 points. This evidence is vital for physicians practicing in resource-constrained environments, offering a validated, low-cost, group-based alternative to traditional one-to-one physiotherapy, which can significantly enhance patient access to core OA treatments.
Citation: Wainwright TW, Immins T, Docherty S, Saunders G, Hawton A, Goodwin E, Rees T, Low M, Samways J, Webley F, Howard N, Lee PH, Middleton RG. Clinical and cost-effectiveness of a cycling and education intervention versus usual physiotherapy care for the treatment of hip osteoarthritis in the UK (CLEAT): a pragmatic, randomised, controlled trial. Lancet Rheumatol. 2025. DOI: https://doi.org/10.1016/ S2665-9913(25)00102-X
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