{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:39:24Z","timestamp":1787017164179,"version":"build-2736575974"},"reference-count":50,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2021,12,12]],"date-time":"2021-12-12T00:00:00Z","timestamp":1639267200000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Danish Rheumatism Association","award":["0 - Not applicable"],"award-info":[{"award-number":["0 - Not applicable"]}]},{"name":"the Physiotherapy Practice Foundation, Denmark","award":["0 - Not applicable"],"award-info":[{"award-number":["0 - Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,11,1]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate 1-year cost-effectiveness of an 8-week supervised education and exercise programme delivered in primary care to patients with symptomatic knee or hip osteoarthritis (OA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A registry-based pre\u2013post study linking patient-level data from the Good Life with osteoArthritis in Denmark (GLA:D) registry to national registries in Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>16 255 patients with symptomatic knee or hip OA attending GLA:D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>GLA:D is a structured supervised patient education and exercise programme delivered by certified physiotherapists and implemented in Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Adjusted healthcare costs per Quality-Adjusted Life Year (QALY) gained from baseline to 1 year (ratio of change in healthcare costs to change in EuroQoL 5-Dimensions 5-Level questionnaire (EQ-5D)). All adjusted measures were estimated using a generalised estimating equation gamma regression model for repeated measures. Missing data on EQ-5D were imputed with Multiple Imputations (3 months: 23%; 1 year: 39 %).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Adjusted change in healthcare cost was 298\u20ac (95% CI: 206 to 419) and 640\u20ac (95% CI: 400 to 1009) and change in EQ-5D was 0.035 (95% CI: 0.033 to 0.037) and 0.028 (95% CI: 0.025 to 0.032) for knee and hip patients, respectively. Hence estimated adjusted healthcare costs per QALY gained was 8497\u20ac (95% CI: 6242 to 11 324) for knee and 22 568\u20ac (95% CI: 16 000 to 31 531) for hip patients. In patients with high compliance, the adjusted healthcare costs per QALY gained was 5438\u20ac (95% CI: 2758 to 9231) for knee and 17 330\u20ac (95% CI: 10 041 to 29 364) for hip patients. Healthcare costs per QALY were below conventional thresholds for willingness-to-pay at 22 804\u20ac (20 000\u00a3) and 43 979\u20ac (US$50 000), except the upper limit of the 95% CI for hip patients which was in between the two thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A structured 8-week supervised education and exercise programme delivered in primary care was cost-effective at 1 year in patients with knee or hip OA supporting large-scale implementation in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-049541","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T11:33:05Z","timestamp":1639395185000},"page":"e049541","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Cost-effectiveness of an 8-week supervised education and exercise therapy programme for knee and hip osteoarthritis: a pre\u2013post analysis of 16\u2009255 patients participating in Good Life with osteoArthritis in Denmark (GLA:D)"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-1175","authenticated-orcid":false,"given":"Dorte T","family":"Gr\u00f8nne","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5425-2199","authenticated-orcid":false,"given":"Ewa M","family":"Roos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke","family":"Ibsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Kjellberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4336-7059","authenticated-orcid":false,"given":"S\u00f8ren T","family":"Skou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"key":"2024112512325898000_11.12.e049541.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2014.44"},{"key":"2024112512325898000_11.12.e049541.2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket463"},{"key":"2024112512325898000_11.12.e049541.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2016.03.012"},{"key":"2024112512325898000_11.12.e049541.4","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-216515"},{"key":"2024112512325898000_11.12.e049541.5","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202745"},{"key":"2024112512325898000_11.12.e049541.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2019.06.011"},{"key":"2024112512325898000_11.12.e049541.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2013.11.012"},{"key":"2024112512325898000_11.12.e049541.8","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1002\/art.41142","article-title":"2019 American College of Rheumatology\/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee","volume":"72","author":"Kolasinski","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"2024112512325898000_11.12.e049541.9","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2015-095424"},{"key":"2024112512325898000_11.12.e049541.10","article-title":"Exercise for osteoarthritis of the hip","volume":"21","author":"Fransen","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"2024112512325898000_11.12.e049541.11","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22891"},{"key":"2024112512325898000_11.12.e049541.12","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1111\/1756-185X.13480","article-title":"Who seeks physiotherapy or exercise treatment for hip and knee osteoarthritis? 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