The goal of this clinical trial is to determine the clinical effectiveness of a Chronic
Care Model (CCM) named Risk Assessment and Management Program on Knee OA (RAMP-Knee OA)
in adults with knee Osteoarthritis (Knee OA) at 52 weeks. RAMP-knee OA is designed based
on the validated framework of CCM, which identifies six important components including
self-management support, clinical information systems, delivery system redesign, decision
support, health care organization, and community resources.
The main questions the study aims to answer are:
In comparison with people undergoing usual care, whether:
Participants in the RAMP-Knee OA group will report greater improvement in the
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale
Participants in the RAMP-Knee OA group will report greater improvement in physical
function, self-management efficacy, lower limb muscle mass, psychosocial health, and
quality of life
Participants will be screened for eligibility to participate. After confirming
eligibility, participants will complete the baseline assessment and be randomized into
one of the following groups (n=114 for each group):
RAMP Knee-OA group: Participants will be referred to the RAMP-Knee OA clinic
operated by a Registered Nurse, which will be a face-to-face consultation scheduled
every 4 months following patients' usual clinic appointments. A total of 4 sessions
will be provided for each enrolled participant over one year. The content of the
Programme centers around arthritis education, structure-land base exercise, and
weight management, with the additional component of counseling support and dietary
advice on musculoskeletal health.
Usual care group: Participants allocated to the usual care group will continue with
their standard usual care (follow-up appointment at General Out Patient Clinic
(GOPC) is typically every 4 months). The management approach for knee OA and other
chronic diseases will be solely at the discretion of the attending physicians.
Outcomes will be measured at baseline, week 16, week 32, and week 52. Demographic data
and knee pain duration will be collected at baseline assessment. Outcomes to measure
include the severity of knee pain, physical function, level of physical activity,
self-efficacy, level of anxiety and depression, insomnia, loneliness, health-related
quality of life, and lower limb muscle mass. The use of co-intervention, analgesics, and
other over-the-counter drugs will be recorded.
The baseline characteristics of the two groups will be compared using the independent
samples t-test or the Mann-Whitney test for continuous variables and chi-square test for
categorical variables.