Defining the Content of an Opportunistic Osteoarthritis Consultation With Primary Health Care Professionals: A Delphi Consensus Study

Abstract

Objective. To define the core content for an opportunistic consultation between a health care professional (HCP) and a patient with osteoarthritis (OA) in primary care.Methods. An ideas generation round and a 2-round Delphi postal consensus study allowed participants to rank the importance of tasks for an opportunistic consultation. The study was conducted with a lay group (n ‫؍‬ 18) and 3 groups of HCPs (n ‫؍‬ 30 for general practitioners, n ‫؍‬ 19 for practice nurses, and n ‫؍‬ 37 for allied health professionals). Results. The ideas generation round formulated 35 consultation tasks. There was a 50% response rate to the 2-round postal exercise (n ‫؍‬ 52). Consensus was reached on 12 tasks for an opportunistic OA consultation using a >80% level of agreement across all groups. Three of these consultation tasks were defined at 100%. The 3 tasks were questions asked by the HCP about how things are going with the condition, the type and amount of pain the patient has, and whether the patient is taking regular analgesia. Conclusion. In a Delphi study to define the content of an opportunistic primary care OA consultation, 12 consultation tasks provided the content of a comprehensive consultation. Three of these tasks with 100% agreement could be adopted in any multidisciplinary consultation for OA in primary care. Inquiring about the condition, the type and amount of pain the patient has, and whether analgesia is being taken forms a core set of questions that are considered important by both lay and health professional groups in an opportunistic consultation.

What Do People With Knee or Hip Osteoarthritis Need to Know? An International Consensus List of Essential Statements for Osteoarthritis

“…The large Delphi panel, consisting of international osteoarthritis experts and consumers with osteoarthritis, ensures a robust list of messages that are consistent with research evidence and conveyed in patient-friendly language. Although the response rate for round 1 was only 60%, this response rate is better than 2 recent Delphi studies of osteoarthritis experts (28,29), and the vast majority of the original panel was retained in subsequent rounds. A strength of our study is the inclusion of osteoarthritis consumers on the expert panel.…”

Multisite peripheral joint pain: a cross-sectional study of prevalence and impact on general health, quality of life, pain intensity and consultation behaviour

“…Comparative studies most often report consultation prevalence from medical records, take their estimates from the general population, and estimate consultation prevalence for OA rather than peripheral joint pain [ 4 , 24 , 25 ]. Consultation data gained via self-report methods, such as this study, may not offer the precision of medical records for conditions with a diagnosis, such as OA, but may provide a better estimate of any consultation in which joint pain is mentioned opportunistically [ 26 , 27 ].…”

Effect of a model consultation informed by guidelines on recorded quality of care of osteoarthritis (MOSAICS): a cluster randomised controlled trial in primary care

“…The development of the intervention has been published elsewhere 17 , 23 , 24 . Briefly, using the findings of two consensus exercises 23 , 25 and theoretical models to guide self-management 26 and support patient behaviour change 27 , 28 , a model OA consultation was developed. This comprised an enhanced initial consultation with the GP and provision of a nurse-led OA clinic, both supported by use of an OA Guidebook, and was delivered to patients aged ≥45 years presenting with clinical OA ( Appendix 1 ).…”