Virtual or in-person: does it matter? Comparing pain, function, quality of life, self-efficacy and physical function outcomes of virtual, hybrid and in-person GLA:D Canada participants.

Abstract

Objective: This study aimed to determine if program format (in-person, virtual, hybrid) results in differences in three-month outcomes of pain, function, quality of life, self-efficacy and chair stands in a hip/knee osteoarthritis management program.

Methods: A secondary analysis of the GLA:D^TM Canada database was completed. Multiple linear regression was completed for pain and function, analysis of covariance for quality of life and self-efficacy, and negative binomial regression was completed to analyze chair stands. Outcome measures included the 12-item Knee/Hip Injury and Osteoarthritis Outcome Score (pain, quality of life and physical function subscales), Arthritis Self-efficacy Scale (self-efficacy), and 30-second chair stand test. Models were adjusted for different covariates. .

Results: The analyses included 5062 individuals with knee and/or hip osteoarthritis who completed the program between January 2019- March 2024 (76.7% female sex, mean age = 67.27 years, mean BMI = 29.51 kg/m²). When compared to in-person formats, there was no difference in virtual or hybrid formats at three months for pain, quality of life, or self-efficacy. When compared to in-person, the virtual format resulted in lower function scores B=-1.71 95% CI (-2.78, -0.63) and the hybrid format performed 3% fewer chair stands at 3-months incidence rate ratio = 0.97 95% CI (0.93, 0.99), which is not a clinically important change.

Conclusions: The GLA:D^TM Canada program appears effective in virtual, hybrid and in-person formats. With the known barriers of strictly in-person formats, these results provide further support for research and implementation of virtual and hybrid approaches for helping individuals manage osteoarthritis.