Patient and healthcare factors associated with treatment response in patients with hand osteoarthritis: secondary analyses from a randomised controlled, noninferiority trial

Objectives This study aimed to explore patient- and healthcare-related factors associated with treatment response 6 months after receiving recommended care for hand osteoarthritis (HOA) in specialist health services. Methods We analysed data from 340 individuals with HOA who participated in a randomised controlled trial. Participants received patient education, medication, and/or guided hand exercises. Those with thumb carpometacarpal (CMC1-OA) were also offered a thumb orthosis. Multivariable logistic regression analyses examined associations between treatment response (OMERACT-OARSI responder criteria) and patient-related variables (age, sex, severity of CMC1-OA, pain, stiffness, grip strength, hand function, and general health), and patients' experience with care (PasOpp questionnaire). Results Eighty percent of participants were women, and the mean age was 63.6 years. After 6 months, 96 participants (28%) were classified as OMERACT-OARSI responders. Less severe CMC1-OA (Kellgren-Lawrence grade <2) was associated with nearly doubled odds of being a responder (odds ratio [OR] 1.95, 95% CI: 1.07-3.55). Higher baseline pain intensity also increased the likelihood of good response (OR 1.18, 95% CI: 1.05-1.33). Regarding care-related factors, high scores on ‘confidence in health professionals' competence' (OR 2.09, 95% CI: 1.10-3.96) and ‘perceived benefit of treatment' (OR 1.74, 95% CI: 1.28-2.36) were positively associated with good response. Unexpectedly, higher scores on ‘sufficient information about diagnosis and treatment' were associated with a lower probability of good response (OR 0.63, 95% CI: 0.42-0.96). Conclusions Findings highlight the importance of early, individualized care and suggest that providing too much detailed information may unintentionally reduce patients' hope for improvement.