Injections for osteoarthritis: A delphi study
Research type
Research Study
Full title
Identifying priorities for future research into intra-articular corticosteroid injections for osteoarthritis: a Delphi study
IRAS ID
284918
Contact name
Vikki Wylde
Contact email
Sponsor organisation
University of Bristol
Duration of Study in the UK
1 years, 1 months, 31 days
Research summary
Summary of Research
Osteoarthritis is a condition that causes joints to become painful and stiff. Management of osteoarthritis involves reducing pain and maintaining function. Simple treatments include activity modification, staying active to maintain muscle strength and taking pain medication. Complex treatments include joint replacement (replacing the painful joint with an artificial joint), which may be required for those with pain that cannot be well controlled by other means. Before a joint replacement is considered, it is possible to use other techniques, such as injections into the affected joint, to try to reduce pain. These injections are most commonly used for knee osteoarthritis. The injection usually contains both an anaesthetic to help with the pain and a steroid to reduce the inflammation (swelling, redness, heat and pain) within the joint. It is known that these injections can help with pain if used infrequently and that their use is recommended by a variety of organisations, including the NHS. However, little is known about the effect of using repeated injections.We are doing a large programme of work into injections for osteoarthritis. As part of this work, we want to do a study to find out what future research in this area is needed and the most acceptable way of doing this. To do this, we will ask 100 people including patients, healthcare professionals, commissioners and researchers to take part in the study. Each participant will be sent three questionnaires over a 6-8 month period. The first questionnaire will ask people to suggest up to five topics for research. These suggestions, along with topics identified from our larger programme of work, will be collected together and used in a second questionnaire. In the second questionnaire, people will be asked to rate how important they think each research topic is from 1-9. We will look at all the responses and the research topics with the top average ratings will then be sent to all the participants again in a final questionnaire. A summary of the average group ratings for each research topic will also be sent to people, and they will be given the opportunity to keep their answers the same, or change them, based on the group feedback. Through this method, we will generate a list of questions for future research into injections for osteoarthritis that are important to patients, healthcare professionals, researchers and commissioners.
Summary of Results
Aims
This study aimed to find out what future research is needed about ‘corticosteroid’ or ‘steroid’ injections for osteoarthritis.Study design
91 patients, health professionals and researchers completed three questionnaires. In the first questionnaire, participants each suggested up to five topics for research.In the second questionnaire, participants were provided with a list of research questions suggested in Round 1 and asked to rate the importance of each research question.
In the third questionnaire, participants were provided with a shorter list of the research questions that were rated as most important by people in Round 2. We also let people how the group rated each research question, and participants had the option of keeping their ratings the same or changing them.
The final 14 research questions that were considered important were:
• What are the long-term effects of repeated steroid injections?
• What outcomes are important to patients?
• Are steroid injections as good as other non-surgical treatments at reducing osteoarthritis symptoms?
• Can the duration of benefit from a steroid injection be increased?
• When in the osteoarthritis treatment pathway should patients be offered steroid injections?
• How many steroid injections is it safe for patients to receive?
• Do steroid injections reduce osteoarthritis symptoms?
• Are steroid injections good value for money for the NHS?
• Is it possible to predict which patients are most likely to benefit from steroid injections?
• Do steroid injections delay the need for joint replacement?
• What are patients' experiences of having steroid injections?
• What is the best dose of steroid to use?
• What type of steroid works the best?
• Do steroid injections help people to do exercises/ physiotherapy?What next?
We are now working to tell people about the results, including health professionals, researchers, funders of research and the public.REC name
North of Scotland Research Ethics Committee 2
REC reference
21/NS/0070
Date of REC Opinion
21 May 2021
REC opinion
Favourable Opinion