Personalized Treatment Goals in Hand and Wrist Care: Understanding the Influence of Baseline and Target Score on Goal Achievement

OBJECTIVE: To investigate the independent association between the initial baseline and target scores and the probability of achieving personal treatment goals in patients with various hand and wrist conditions. DESIGN: Prospective cohort study. SETTING: Data were collected as part of usual care at a specialized clinic for hand surgery and therapy. PARTICIPANTS: Adult patients (N= 6246) who received surgical or nonsurgical treatment for thumb base osteoarthritis, carpal tunnel syndrome, trigger finger, Morbus de Quervain, Dupuytren disease, or triangular fibrocartilaginous complex injury and completed the patient-specific needs evaluation before their first consultation and three months after treatment initiation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The primary outcome was whether patients achieved their personal meaningful gain (PMG) 3 months after treatment. The PMG represents the improvement an individual aims to achieve in a domain relevant to them, given their baseline score. RESULTS: A total of 2445 patients (39%) achieved their PMG. A higher baseline score, reflecting less severe symptoms or functional limitations, was associated with increased odds of reaching the PMG (odds ratio [OR], 1.39; 95% CI, 1.09-1.76; P=.007). A higher target score was associated with lower odds of reaching the PMG (OR, 0.67; 95% CI, 0.60-0.73; P