“It probably doesn’t always make it into the top of the list, I'll be honest with you:” primary care physicians experiences with prescribing exercise for knee osteoarthritis

Christiansen, Meredith B.; Webster, Fiona; Christian, Jennifer; Waugh, Esther J.; Gakhal, Natasha; King, Lauren; Hawker, Gillian; White, Daniel K.

doi:10.1016/j.joca.2018.02.083

Cited by 10 publications

(19 citation statements)

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“…After removal of duplicates and exclusion of articles based on title or abstract, 93 potentially relevant articles remained for full-text screening. Ultimately, 36 articles were included in the qualitative synthesis 27–62…”

Section: Resultsmentioning

confidence: 99%

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Barriers and facilitators perceived by healthcare professionals for implementing lifestyle interventions in patients with osteoarthritis: a scoping review

et al. 2022

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ObjectiveTo provide an overview of barriers and facilitators that healthcare professionals (HCPs) perceive regarding the implementation of lifestyle interventions (LIs) in patients with hip and/or knee osteoarthritis (OA).DesignScoping review.Data sourcesThe databases PubMed, Embase, CINAHL, PsycINFO and the Cochrane Library were searched from inception up to January 2021.Eligibility criteriaPrimary research articles with a quantitative, qualitative or mixed-methods design were eligible for inclusion if they reported: (1) perceptions of primary and/or secondary HCPs (population); (2) on implementing LIs with physical activity and/or weight management as key components (concept) and (3) on conservative management of hip and/or knee OA (context). Articles not published in English, German or Dutch were excluded.Data extraction and synthesisBarriers and facilitators were extracted by two researchers independently. Subsequently, the extracted factors were linked to a framework based on the Tailored Implementation for Chronic Diseases checklist.ResultsThirty-six articles were included. In total, 809 factors were extracted and subdivided into nine domains. The extracted barriers were mostly related to non-optimal interdisciplinary collaboration, patients’ negative attitude towards LIs, patients’ low health literacy and HCPs’ lack of knowledge and skills around LIs or promoting behavioural change. The extracted facilitators were mostly related to good interdisciplinary collaboration, a positive perception of HCPs’ own role in implementing LIs, the content or structure of LIs and HCPs’ positive attitude towards LIs.ConclusionsMultiple individual and environmental factors influence the implementation of LIs by HCPs in patients with hip and/or knee OA. The resulting overview of barriers and facilitators can guide future research on the implementation of LIs within OA care. To investigate whether factor frequency is related to the relevance of each domain, further research should assess the relative importance of the identified factors involving all relevant disciplines of primary and secondary HCPs.PROSPERO registration numberCRD42019129348.

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Section: Resultsmentioning

confidence: 99%

“…Lack of knowledge or skills around LIs or promoting behavioural change 27 29 33 41 42 45 47 49–51 56 60 61…”

Section: Resultsmentioning

confidence: 99%

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Barriers and facilitators perceived by healthcare professionals for implementing lifestyle interventions in patients with osteoarthritis: a scoping review

et al. 2022

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“…In line with previous research (Morris et al, 2011, Alami et al, 2011, we found people with OA and comorbidity prioritise their conditions themselves, to manage treatments and daily life with OA often viewed as the priority condition (as a result of its impact on mobility, PA and social functioning). In contrast to patients' priorities, HCPs tend to prioritise other conditions above OA (Alami et al, 2011;Christiansen et al, 2020), leading to a potential mismatch in provision of patient-centred care.…”

Section: Comparison To Existing Literaturementioning

confidence: 99%

The attitudes towards, and beliefs about, physical activity in people with osteoarthritis and comorbidity: A qualitative investigation

McKevitt

Jinks

Healey

et al. 2021

Musculoskeletal Care

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Objective: To investigate the attitudes towards, and beliefs about, physical activity (PA) in older adults with osteoarthritis (OA) and comorbidity to understand experiences and seek ways to improve PA participation.Methods: Semi-structured interviews with adults aged ≥45, with self-reported OA and comorbidity (N = 17). Face-to-face interviews explored participant perspectives regarding; (1) attitudes and beliefs about PA in the context of OA and comorbidity and (2) how people with OA and comorbidity could be encouraged to improve and maintain PA levels. Data were transcribed verbatim and inductive thematic analysis was undertaken using a framework approach. Results: Participants did not conceptualise multiple long-term conditions (LTCs) together and instead self-prioritised OA over other LTCs. Barriers to PA included uncertainty about both the general management of individual LTCs and the effectiveness of PA for their LTCs; and, negative perceptions about their health, ageing and PA. Participants experienced dynamic and co-existing barriers to PA, and problematized this as a multi-level process, identifying a barrier, then a solution, followed by a new barrier. Facilitators of PA included social support and support from knowledgeable healthcare professionals (HCPs), together with PA adapted for OA and comorbidity and daily life. PA levels could be increased through targeted interventions to increase self-efficacy for managing OA alongside other LTCs and self-efficacy for PA. Conclusion: People with OA and comorbidity experience complicated PA barriers. To increase PA levels, tailored PA interventions could include HCP and social support to anticipate and overcome multi-level PA barriers and target increased self-efficacy for LTC management and PA.

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“…Another barrier to physical activity counseling is providers’ lack of confidence and training in this area. 20,45,57 -62 Specific to arthritis, providers report needing additional education, 32 not knowing appropriate physical activity types, 63 and addressing patient concerns about physical activity causing joint damage. 64 In the current study, the strongest associations across all outcomes (assessment, recommendation, and both) were observed for PCPs seeing the greatest volume of adults with arthritis weekly.…”

Section: Discussionmentioning

confidence: 99%

Physical Activity Assessment and Recommendation for Adults With Arthritis by Primary Care Providers—DocStyles, 2018

et al. 2020

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Purpose: To examine primary care providers' (PCPs) physical activity assessment and recommendation behaviors for adults with arthritis. Design: Cross-sectional. Setting: 2018 DocStyles online national market research survey of US physicians and nurse practitioners. Sample: 1,389 PCPs seeing adults with arthritis. Measures: 2 independent behaviors (assessment and recommendation) as 3 non-mutually exclusive groups: “always assesses,” “always recommends,” and “both” (“always assesses and recommends”). Analysis: Calculated percentages of each group (overall and by PCP characteristics), and multivariable-adjusted prevalence ratios (PRs) using binary logistic regression. Results: Among PCPs, 49.2% always assessed and 57.7% always recommended physical activity; 39.7% did both. Across all 3 groups, percentages were highest for seeing ≥20 adults with arthritis weekly (“both”: 56.4%; “always assesses”: 66.7%; “always recommends”: 71.3%) and lowest among obstetrician/gynecologists (“both”: 26.9%; “always assesses”: 36.8%; “always recommends”: 40.7%). Multivariable-adjusted associations were strongest for seeing ≥20 adults with arthritis weekly (referent: 1-9 adults) and each of “always assesses” (PR = 1.5 [95% confidence interval (CI): 1.3−1.8] and “both” (PR = 1.6 [95% CI: 1.4−1.9]). Conclusions: Approximately 40% of PCPs sampled always engaged in both behaviors (assessing and recommending physical activity) with adults with arthritis; seeing a high volume of adults with arthritis was consistently related to engaging in each behavior. Evidence-based approaches to support PCP counseling include offering provider education and training, raising awareness of available resources, and using health system supports.

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“It probably doesn’t always make it into the top of the list, I'll be honest with you:” primary care physicians experiences with prescribing exercise for knee osteoarthritis

Cited by 10 publications

References 0 publications

Barriers and facilitators perceived by healthcare professionals for implementing lifestyle interventions in patients with osteoarthritis: a scoping review

Barriers and facilitators perceived by healthcare professionals for implementing lifestyle interventions in patients with osteoarthritis: a scoping review

The attitudes towards, and beliefs about, physical activity in people with osteoarthritis and comorbidity: A qualitative investigation

Physical Activity Assessment and Recommendation for Adults With Arthritis by Primary Care Providers—DocStyles, 2018

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