Full Length Article| Volume 35, ISSUE 3, P447-453, July 2022

High baseline pain is associated with treatment adherence in persons diagnosed with thumb base osteoarthritis: An observational study


      • High baseline pain was associated with better adherence over 12 weeks in participants with thumb base osteoarthritis (OA).
      • Baseline function was not associated with adherence over the same period.
      • Strategies to improve adherence should be targeted to those reporting lower baseline pain as they may be less likely to adhere.
      • Future research should evaluate the validity and reliability of adherence measures for thumb base OA interventions.



      Thumb osteoarthritis (OA) is a common and disabling condition. Adherence to prescribed conservative interventions may affect outcomes of thumb OA trials.


      The aim of the study was to determine whether baseline pain and hand function is associated with treatment adherence over 12 weeks in participants with thumb base OA.

      Study design

      Observational cohort study nested within a randomized-controlled trial.


      Ninety-four participants from the intervention group were included in the analysis. Baseline pain and function were assessed using a 100 mm Visual Analogue Scale and the Functional Index for Hand Osteoarthritis questionnaire (0-30), respectively. Participants received a combination of treatments including education, orthosis, hand exercises, and topical anti–inflammatory gel. Adherence was measured using a daily self-reported diary. Participants were classified as non–adherent, partially adherent or fully adherent if they completed none, 1 and/or 2 or all 3 of the interventions as prescribed. Ordinal logistic regression modelling was performed.


      At 12-week follow-up, half of the participants were fully adherent to the treatments (n = 46, 48.9%), 30.9% of participants were partially adherent (n = 29) and 20.2% were non–adherent (n = 19, 20.2%). High baseline pain was a significantly associated with better adherence in the unadjusted model [OR = 3.15, 95% CI (1.18, 8.42)] and adjusted model [OR = 3.20, 95% CI (1.13, 8.20)]. Baseline function was not associated with adherence [OR = 1.03, 95% CI (0.47, 2.23)].


      High baseline pain was associated with better adherence in participants with thumb base OA. Higher baseline functional impairment was not associated with better adherence.


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      JHT Read for Credit

      Quiz: # 860

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1.
        Program adherence was assessed at approximately __________ post initiation of treatment
        • a.
          1 month
        • b.
          1 year
        • c.
          12 weeks
        • d.
          6 weeks
      • # 2.
        What % of the patients were considered compliant/adherent with their treatment
        • a.
        • b.
        • c.
        • d.
      • # 3.
        There was a significant positive correlation between
        • a.
          gender and program adherence
        • b.
          age and program adherence
        • c.
          baseline function and program adherence
        • d.
          high baseline pain and program adherence
      • # 4.
        EULAR guidelines include
        • a.
          retrograde massage
        • b.
          steroid injection
        • c.
          topical NSAIDs
        • d.
          topical corticosteroid cream and ultrasound (phonophoresis)
      • # 5.
        The protocol included 4 face-to-face hospital visits
        • a.
          not true
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.