A new study of digital osteoarthritis treatment shows revolutionary results

A new study, published in Journal of Medical Internet Research, states that osteoarthritis can be treated successfully and long term with a digital intervention. The outcomes are the best that has ever been published for the disease. The digital treatment Joint Academy shows that it can deliver meaningful clinical outcomes on patient pain, physical function, quality of life as well as reducing medication and avoiding surgery. All with statistical significance.

The results point to clear improvements for people with osteoarthritis, a condition that affects more than 30 million americans and 45 million Europeans.

With the physical exercises provided as treatment by Joint Academy, the 350 participants in the study decreased their pain with 24% and increased their functionality with 21% after six weeks. A notable 22% also stated that they were able to cut back on the medication they had previously taken for their osteoarthritis - and 25% of those who had planned surgery chose not to go through with the operation.

This means that the digital treatment program provided by Joint Academy can be used to decrease the amount of surgeries made. Fewer surgeries means more preventive care, a more value-based focus, and less costs for hospitalizations and medications. In addition, a lifestyle-based treatment increases the quality of life for each patient due to less side effects from medications.

The study was conducted by Arthro, an innovative company in e-health with offices in Sweden and the United States, in collaboration with Lund University. The purpose was to investigate the digital treatment program Joint Academy’s effect on knee- and hip osteoarthritis.

- The results confirm what we’ve seen in a previous study: that the participants increase their functionality, decrease their pain, and are happy with the treatment. The study also shows that it’s enough to do the physical exercises a few times a day, which makes it easy to fit into each individual’s everyday schedule, says Leif Dahlberg, chief medical officer at Arthro, the company behind Joint Academy.

The price of osteoarthritis

Living with osteoarthritis can cause great physical discomfort as well as both mental- and economic burdens for the person affected by the condition. The disease also brings both direct and indirect costs for society as a whole in the form of extensive sick leaves and early retirement. As for treatment, the calculated cost for an insurance company per patient that need total knee replacement surgery is estimated to $40.000 - and the total costs for those over the age of 65 who need surgery is can be up to $234.000.000. This means that Joint Academy has the potential to reduce societal costs since a fourth of the participants in the study stated that they no longer wish to proceed with their planned surgery.

- In order to avoid sick leaves and both mental- and physical illness, it’s important to start the treatment as early as possible. And by making education and the exercises easily available, Joint Academy makes it much easier for each patient to take part of their treatment and affect their outcomes. This, in turn, places less strain on the health systems, Leif Dahlberg explains.

Replacing drugs with physical activity

It is also crucial to spread information about the condition since misinformation leads to inefficient treatment - which leads to unnecessary costs for both society in general and healthcare systems in particular. For example, excessive medication with prescription-based drugs doesn’t give better outcomes for the patient than NSAID-painkillers such as advil or aspirin. Treating chronic pain with opioids instead increases the risk of addiction and even death. This means that treatments that build upon physical training and lifestyle changes are incredibly important.

The participants in the study had an average age of 62 and of 350 individuals, 239 were women. Before the treatment, 22% stated that they were afraid of being physically active - and at the end of the treatment, only 7% said the same thing.

- Since physical activity is such a central part of the treatment for osteoarthritis as well as for health in general, it’s very important to dare to be active. And since more and more people are affected by osteoarthritis all over the western world in particular, we see it as an important task to be able to offer a treatment method that works in the long run for individual and society alike, Leif Dahlberg concludes.

How osteoarthritis is treated with Joint Academy

Joint Academy is a treatment program that is based on clinical evidence and extensive experience from physiotherapists. A team of researchers and software developers built the online platform as an easy solution for personalized osteoarthritis care. Through the program, people with osteoarthritis get a program with physical exercises, education about their condition, and support from a personal physiotherapist in order to make critical lifestyle changes. The physical exercises are chosen to strengthen the affected joints and stimulate the growth of cartilage.

The chronic condition osteoarthritis is primarily treated with physical activity and education in accordance with international guidelines and research. The majority of the patients regain their mobility and decrease their symptoms with this treatment. For a minority, surgery can become a necessity.

How artificial intelligence works in Joint Academy

Arthro works with artificial intelligence (AI) in order to discover what presumptive patients will benefit from Joint Academy. This has been done by creating a screening with questions related to health and joint pain. The answers from each potential patient are fed into a trained machine learning model that makes predictions on the expected outcome of each patient. The model has been trained on outcomes from more than 75,000 patients (that have completed the swedish artrosskolan). Based on this, Arthro is able to discover what patients will benefit the most from the digital treatment program.In addition, Arthro’s knowledge about both osteoarthritis and AI is continuously updated since the activities that the patients perform on a daily basis repeatedly lead to new insights.

1. Estimated from Lawrence CR et al. Estimates of the Prevalence of Arthritis and Other Rheumatic Conditions in the United States, Part II. Arthritis Rheum. 2008 Jan; 58(1): 26–35. PMCID: PMC3266664.

2. Dibonaventura MD, Gupta S, Mcdonald M, Sadosky A, Pettitt D, Silverman S. Impact of self-rated osteoarthritis severity in an employed population: cross-sectional analysis of data from the national health and wellness survey. Health Qual Life Outcomes. 2012;10:30. PMID 22420468.

The research article is freely available on the Internet at:
http://www.jmir.org/2017/12/e422