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McHugh N, Maguire Á, Handel I, Tillett W, Morris J, Hawkins N, Cavill C, Korendowych E, Mughal F. Evaluation of the Economic Burden of Psoriatic Arthritis and the Relationship Between Functional Status and Healthcare Costs. J Rheumatol 2019; 47:701-707. [PMID: 31416922 DOI: 10.3899/jrheum.190083] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This analysis aimed to evaluate the economic burden of patients with psoriatic arthritis (PsA) on the UK healthcare system and estimate the relationship between functional status and direct healthcare costs. METHODS Functional status [measured using the Health Assessment Questionnaire-Disability Index (HAQ-DI)], demographics, disease history, and healthcare resource use data were extracted from a cohort of patients at the Royal National Hospital for Rheumatic Diseases, Bath, UK. Each resource use item per patient was then allocated a unit cost. Linear regression models were used to predict costs as a function of HAQ-DI. Medication costs were not included in the primary analysis, which was carried out from the UK National Health Service perspective. RESULTS Data were available for 101 patients. Mean HAQ-DI score was 0.84 (SD 0.75) and mean age at HAQ-DI measurement was 57.8 (SD 10.7). Total annual healthcare costs per patient, excluding medication costs, ranged between £174 and £8854, with a mean of £1586 (SD £1639). A 1-point increase in HAQ-DI score was associated with an increase in total costs of £547.49 (standard error £224), with secondary care consultations appearing to be the primary factor. Subgroup analyses suggested higher cost increases in patients with HAQ-DI scores of 2-3 and with a disease duration > 10 years. CONCLUSION Patients with PsA place a significant economic burden on the healthcare system. Functional status is highly correlated with costs and appears to be driven mainly by the cost of secondary care consultations. Results were similar to previous studies in rheumatoid arthritis populations.
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Affiliation(s)
- Neil McHugh
- From the Royal National Hospital for Rheumatic Disease, NHS Foundation Trust, Bath; University of Cambridge, Cambridge; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh; University of Bath, Bath; Cogentia Healthcare Consulting Ltd., Cambridge; University of Glasgow, Glasgow; and Celgene Ltd., Uxbridge, UK. .,J. Morris has received consultancy fees from Celgene Ltd. N. Hawkins and C. Cavill have received grant/research support from Celgene Ltd. F. Mughal was an employee of Celgene Ltd. at the time the study was conducted. .,N. McHugh, MB, ChB, MD, FRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and Department of Pharmacy and Pharmacology, University of Bath; Á. Maguire, MSc, PhD student, Department of Psychology, University of Cambridge; I. Handel, PhD, MS, BVSc, Royal (Dick) School of Veterinary Studies, University of Edinburgh; W. Tillett, BSc, MB, ChB, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and the Department of Pharmacy and Pharmacology, University of Bath; J. Morris, MPH, Cogentia Healthcare Consulting Ltd.; N. Hawkins, PhD, Health Economics and Health Technology Assessment, University of Glasgow; C. Cavill, BSc, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; F. Mughal, MPharm, Celgene Ltd. (formerly).
| | - Áine Maguire
- From the Royal National Hospital for Rheumatic Disease, NHS Foundation Trust, Bath; University of Cambridge, Cambridge; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh; University of Bath, Bath; Cogentia Healthcare Consulting Ltd., Cambridge; University of Glasgow, Glasgow; and Celgene Ltd., Uxbridge, UK.,J. Morris has received consultancy fees from Celgene Ltd. N. Hawkins and C. Cavill have received grant/research support from Celgene Ltd. F. Mughal was an employee of Celgene Ltd. at the time the study was conducted.,N. McHugh, MB, ChB, MD, FRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and Department of Pharmacy and Pharmacology, University of Bath; Á. Maguire, MSc, PhD student, Department of Psychology, University of Cambridge; I. Handel, PhD, MS, BVSc, Royal (Dick) School of Veterinary Studies, University of Edinburgh; W. Tillett, BSc, MB, ChB, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and the Department of Pharmacy and Pharmacology, University of Bath; J. Morris, MPH, Cogentia Healthcare Consulting Ltd.; N. Hawkins, PhD, Health Economics and Health Technology Assessment, University of Glasgow; C. Cavill, BSc, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; F. Mughal, MPharm, Celgene Ltd. (formerly)
| | - Ian Handel
- From the Royal National Hospital for Rheumatic Disease, NHS Foundation Trust, Bath; University of Cambridge, Cambridge; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh; University of Bath, Bath; Cogentia Healthcare Consulting Ltd., Cambridge; University of Glasgow, Glasgow; and Celgene Ltd., Uxbridge, UK.,J. Morris has received consultancy fees from Celgene Ltd. N. Hawkins and C. Cavill have received grant/research support from Celgene Ltd. F. Mughal was an employee of Celgene Ltd. at the time the study was conducted.,N. McHugh, MB, ChB, MD, FRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and Department of Pharmacy and Pharmacology, University of Bath; Á. Maguire, MSc, PhD student, Department of Psychology, University of Cambridge; I. Handel, PhD, MS, BVSc, Royal (Dick) School of Veterinary Studies, University of Edinburgh; W. Tillett, BSc, MB, ChB, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and the Department of Pharmacy and Pharmacology, University of Bath; J. Morris, MPH, Cogentia Healthcare Consulting Ltd.; N. Hawkins, PhD, Health Economics and Health Technology Assessment, University of Glasgow; C. Cavill, BSc, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; F. Mughal, MPharm, Celgene Ltd. (formerly)
| | - William Tillett
- From the Royal National Hospital for Rheumatic Disease, NHS Foundation Trust, Bath; University of Cambridge, Cambridge; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh; University of Bath, Bath; Cogentia Healthcare Consulting Ltd., Cambridge; University of Glasgow, Glasgow; and Celgene Ltd., Uxbridge, UK.,J. Morris has received consultancy fees from Celgene Ltd. N. Hawkins and C. Cavill have received grant/research support from Celgene Ltd. F. Mughal was an employee of Celgene Ltd. at the time the study was conducted.,N. McHugh, MB, ChB, MD, FRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and Department of Pharmacy and Pharmacology, University of Bath; Á. Maguire, MSc, PhD student, Department of Psychology, University of Cambridge; I. Handel, PhD, MS, BVSc, Royal (Dick) School of Veterinary Studies, University of Edinburgh; W. Tillett, BSc, MB, ChB, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and the Department of Pharmacy and Pharmacology, University of Bath; J. Morris, MPH, Cogentia Healthcare Consulting Ltd.; N. Hawkins, PhD, Health Economics and Health Technology Assessment, University of Glasgow; C. Cavill, BSc, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; F. Mughal, MPharm, Celgene Ltd. (formerly)
| | - James Morris
- From the Royal National Hospital for Rheumatic Disease, NHS Foundation Trust, Bath; University of Cambridge, Cambridge; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh; University of Bath, Bath; Cogentia Healthcare Consulting Ltd., Cambridge; University of Glasgow, Glasgow; and Celgene Ltd., Uxbridge, UK.,J. Morris has received consultancy fees from Celgene Ltd. N. Hawkins and C. Cavill have received grant/research support from Celgene Ltd. F. Mughal was an employee of Celgene Ltd. at the time the study was conducted.,N. McHugh, MB, ChB, MD, FRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and Department of Pharmacy and Pharmacology, University of Bath; Á. Maguire, MSc, PhD student, Department of Psychology, University of Cambridge; I. Handel, PhD, MS, BVSc, Royal (Dick) School of Veterinary Studies, University of Edinburgh; W. Tillett, BSc, MB, ChB, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and the Department of Pharmacy and Pharmacology, University of Bath; J. Morris, MPH, Cogentia Healthcare Consulting Ltd.; N. Hawkins, PhD, Health Economics and Health Technology Assessment, University of Glasgow; C. Cavill, BSc, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; F. Mughal, MPharm, Celgene Ltd. (formerly)
| | - Neil Hawkins
- From the Royal National Hospital for Rheumatic Disease, NHS Foundation Trust, Bath; University of Cambridge, Cambridge; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh; University of Bath, Bath; Cogentia Healthcare Consulting Ltd., Cambridge; University of Glasgow, Glasgow; and Celgene Ltd., Uxbridge, UK.,J. Morris has received consultancy fees from Celgene Ltd. N. Hawkins and C. Cavill have received grant/research support from Celgene Ltd. F. Mughal was an employee of Celgene Ltd. at the time the study was conducted.,N. McHugh, MB, ChB, MD, FRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and Department of Pharmacy and Pharmacology, University of Bath; Á. Maguire, MSc, PhD student, Department of Psychology, University of Cambridge; I. Handel, PhD, MS, BVSc, Royal (Dick) School of Veterinary Studies, University of Edinburgh; W. Tillett, BSc, MB, ChB, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and the Department of Pharmacy and Pharmacology, University of Bath; J. Morris, MPH, Cogentia Healthcare Consulting Ltd.; N. Hawkins, PhD, Health Economics and Health Technology Assessment, University of Glasgow; C. Cavill, BSc, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; F. Mughal, MPharm, Celgene Ltd. (formerly)
| | - Charlotte Cavill
- From the Royal National Hospital for Rheumatic Disease, NHS Foundation Trust, Bath; University of Cambridge, Cambridge; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh; University of Bath, Bath; Cogentia Healthcare Consulting Ltd., Cambridge; University of Glasgow, Glasgow; and Celgene Ltd., Uxbridge, UK.,J. Morris has received consultancy fees from Celgene Ltd. N. Hawkins and C. Cavill have received grant/research support from Celgene Ltd. F. Mughal was an employee of Celgene Ltd. at the time the study was conducted.,N. McHugh, MB, ChB, MD, FRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and Department of Pharmacy and Pharmacology, University of Bath; Á. Maguire, MSc, PhD student, Department of Psychology, University of Cambridge; I. Handel, PhD, MS, BVSc, Royal (Dick) School of Veterinary Studies, University of Edinburgh; W. Tillett, BSc, MB, ChB, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and the Department of Pharmacy and Pharmacology, University of Bath; J. Morris, MPH, Cogentia Healthcare Consulting Ltd.; N. Hawkins, PhD, Health Economics and Health Technology Assessment, University of Glasgow; C. Cavill, BSc, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; F. Mughal, MPharm, Celgene Ltd. (formerly)
| | - Eleanor Korendowych
- From the Royal National Hospital for Rheumatic Disease, NHS Foundation Trust, Bath; University of Cambridge, Cambridge; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh; University of Bath, Bath; Cogentia Healthcare Consulting Ltd., Cambridge; University of Glasgow, Glasgow; and Celgene Ltd., Uxbridge, UK.,J. Morris has received consultancy fees from Celgene Ltd. N. Hawkins and C. Cavill have received grant/research support from Celgene Ltd. F. Mughal was an employee of Celgene Ltd. at the time the study was conducted.,N. McHugh, MB, ChB, MD, FRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and Department of Pharmacy and Pharmacology, University of Bath; Á. Maguire, MSc, PhD student, Department of Psychology, University of Cambridge; I. Handel, PhD, MS, BVSc, Royal (Dick) School of Veterinary Studies, University of Edinburgh; W. Tillett, BSc, MB, ChB, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and the Department of Pharmacy and Pharmacology, University of Bath; J. Morris, MPH, Cogentia Healthcare Consulting Ltd.; N. Hawkins, PhD, Health Economics and Health Technology Assessment, University of Glasgow; C. Cavill, BSc, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; F. Mughal, MPharm, Celgene Ltd. (formerly)
| | - Farhan Mughal
- From the Royal National Hospital for Rheumatic Disease, NHS Foundation Trust, Bath; University of Cambridge, Cambridge; Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh; University of Bath, Bath; Cogentia Healthcare Consulting Ltd., Cambridge; University of Glasgow, Glasgow; and Celgene Ltd., Uxbridge, UK.,J. Morris has received consultancy fees from Celgene Ltd. N. Hawkins and C. Cavill have received grant/research support from Celgene Ltd. F. Mughal was an employee of Celgene Ltd. at the time the study was conducted.,N. McHugh, MB, ChB, MD, FRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and Department of Pharmacy and Pharmacology, University of Bath; Á. Maguire, MSc, PhD student, Department of Psychology, University of Cambridge; I. Handel, PhD, MS, BVSc, Royal (Dick) School of Veterinary Studies, University of Edinburgh; W. Tillett, BSc, MB, ChB, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, and the Department of Pharmacy and Pharmacology, University of Bath; J. Morris, MPH, Cogentia Healthcare Consulting Ltd.; N. Hawkins, PhD, Health Economics and Health Technology Assessment, University of Glasgow; C. Cavill, BSc, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; E. Korendowych, PhD, MRCP, Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust; F. Mughal, MPharm, Celgene Ltd. (formerly)
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Eyles JP, Lucas BR, Patterson JA, Williams MJ, Weeks K, Fransen M, Hunter DJ. Does clinical presentation predict response to a nonsurgical chronic disease management program for endstage hip and knee osteoarthritis? J Rheumatol 2014; 41:2223-31. [PMID: 25225284 DOI: 10.3899/jrheum.131475] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To identify baseline characteristics of participants who will respond favorably following 6 months of participation in a chronic disease management program for hip and knee osteoarthritis (OA). METHODS This prospective cohort study assessed 559 participants at baseline and following 6 months of participation in the Osteoarthritis Chronic Care Program. Response was defined as the minimal clinically important difference of an 18% and 9-point absolute improvement in the Western Ontario and McMaster Universities Arthritis Index global score. Multivariate logistic regression modeling was used to identify predictors of response. RESULTS Complete data were available for 308 participants. Those who withdrew within the study period were imputed as nonresponders. Three variables were independently associated with response: signal joint (knee vs hip), sex, and high level of comorbidity. Index joint and sex were significant in the multivariate model, but the model was not a sensitive predictor of response. CONCLUSION Strong predictors of response to a chronic disease management program for hip and knee OA were not identified. The significant predictors that were found should be considered in future studies.
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Affiliation(s)
- Jillian P Eyles
- From the Physiotherapy Department and Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School; Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney, Sydney; Physiotherapy Department, Wollongong Hospital, Wollongong, New South Wales, Australia.J.P. Eyles, BAppSc(Phty); B.R. Lucas, MPH, FACP, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; J.A. Patterson, BScAdv(Hons), MBiostat, Kolling Institute of Medical Research; M.J. Williams, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; K. Weeks, BAppSc(Phty), Physiotherapy Department, Wollongong Hospital; M. Fransen, PhD, MPH, University of Sydney; D.J. Hunter, MBBS, PhD, FRACP, Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney
| | - Barbara R Lucas
- From the Physiotherapy Department and Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School; Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney, Sydney; Physiotherapy Department, Wollongong Hospital, Wollongong, New South Wales, Australia.J.P. Eyles, BAppSc(Phty); B.R. Lucas, MPH, FACP, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; J.A. Patterson, BScAdv(Hons), MBiostat, Kolling Institute of Medical Research; M.J. Williams, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; K. Weeks, BAppSc(Phty), Physiotherapy Department, Wollongong Hospital; M. Fransen, PhD, MPH, University of Sydney; D.J. Hunter, MBBS, PhD, FRACP, Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney
| | - Jillian A Patterson
- From the Physiotherapy Department and Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School; Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney, Sydney; Physiotherapy Department, Wollongong Hospital, Wollongong, New South Wales, Australia.J.P. Eyles, BAppSc(Phty); B.R. Lucas, MPH, FACP, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; J.A. Patterson, BScAdv(Hons), MBiostat, Kolling Institute of Medical Research; M.J. Williams, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; K. Weeks, BAppSc(Phty), Physiotherapy Department, Wollongong Hospital; M. Fransen, PhD, MPH, University of Sydney; D.J. Hunter, MBBS, PhD, FRACP, Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney
| | - Matthew J Williams
- From the Physiotherapy Department and Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School; Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney, Sydney; Physiotherapy Department, Wollongong Hospital, Wollongong, New South Wales, Australia.J.P. Eyles, BAppSc(Phty); B.R. Lucas, MPH, FACP, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; J.A. Patterson, BScAdv(Hons), MBiostat, Kolling Institute of Medical Research; M.J. Williams, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; K. Weeks, BAppSc(Phty), Physiotherapy Department, Wollongong Hospital; M. Fransen, PhD, MPH, University of Sydney; D.J. Hunter, MBBS, PhD, FRACP, Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney
| | - Kate Weeks
- From the Physiotherapy Department and Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School; Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney, Sydney; Physiotherapy Department, Wollongong Hospital, Wollongong, New South Wales, Australia.J.P. Eyles, BAppSc(Phty); B.R. Lucas, MPH, FACP, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; J.A. Patterson, BScAdv(Hons), MBiostat, Kolling Institute of Medical Research; M.J. Williams, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; K. Weeks, BAppSc(Phty), Physiotherapy Department, Wollongong Hospital; M. Fransen, PhD, MPH, University of Sydney; D.J. Hunter, MBBS, PhD, FRACP, Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney
| | - Marlene Fransen
- From the Physiotherapy Department and Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School; Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney, Sydney; Physiotherapy Department, Wollongong Hospital, Wollongong, New South Wales, Australia.J.P. Eyles, BAppSc(Phty); B.R. Lucas, MPH, FACP, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; J.A. Patterson, BScAdv(Hons), MBiostat, Kolling Institute of Medical Research; M.J. Williams, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; K. Weeks, BAppSc(Phty), Physiotherapy Department, Wollongong Hospital; M. Fransen, PhD, MPH, University of Sydney; D.J. Hunter, MBBS, PhD, FRACP, Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney
| | - David J Hunter
- From the Physiotherapy Department and Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School; Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney, Sydney; Physiotherapy Department, Wollongong Hospital, Wollongong, New South Wales, Australia.J.P. Eyles, BAppSc(Phty); B.R. Lucas, MPH, FACP, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; J.A. Patterson, BScAdv(Hons), MBiostat, Kolling Institute of Medical Research; M.J. Williams, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; K. Weeks, BAppSc(Phty), Physiotherapy Department, Wollongong Hospital; M. Fransen, PhD, MPH, University of Sydney; D.J. Hunter, MBBS, PhD, FRACP, Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney.
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