Joint and soft tissue injections in Irish primary care: a survey of GPs’ attitudes and practices

Abstract

BackgroundMusculoskeletal conditions are common in primary care, causing significant morbidity. Intra-articular and soft tissue corticosteroid injections are commonly performed by general practitioners (GPs) internationally. It is unknown how commonly they are performed by GPs in Ireland.AimTo determine the frequency and type of joint and soft tissue injections performed by GPs in Ireland and investigate factors affecting their use.Design & settingA cross-sectional online questionnaire based on previous international research was devised for completion by GPs practicing in the Republic of Ireland.MethodGPs were invited to electronically complete a questionnaire on their practices and attitudes regarding joint and soft tissue injections.Results147 of 204 GPs (72.0%) had performed an intra-articular or soft tissue injection in the preceding year. GPs who were principals, male, or worked in a rural/mixed practice setting were more likely to perform these procedures. The most common injection sites were the shoulder and knee. Participants were confident about performing joint and soft tissue injections. 80.4% had received prior training in this treatment modality, most commonly during their GP training programme.A prolonged wait for secondary care intervention, symptom duration and symptom severity were factors which increased the likelihood of performing injection. Difficulty maintaining skills and medicolegal concerns were common barriers to performing joint and soft tissue injections.ConclusionMost GPs surveyed carried out joint and soft tissue injections, most commonly injecting the shoulder and knee. Irish GPs experience many of the same barriers to performing intraarticular injection as experienced internationally.