Patient Priorities in Osteoarthritis and Comorbid Conditions: A Secondary Analysis of Qualitative Data

Cheraghi-Sohi, Sudeh; Bower, Peter; Kennedy, Anne; Morden, Andrew; Rogers, Anne; Richardson, Jane; Sanders, Tom; Stevenson, Fiona; Ong, Bie Nio

doi:10.1002/acr.21897

Cited by 35 publications

(44 citation statements)

References 43 publications

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“…Clinicians can also use these messages as the basis for verbal education and information provision when managing a patient with hip or knee osteoarthritis. Clinical practice guidelines for osteoarthritis recommend education as a core treatment component (7), and development and distribution of patient educational materials is an essential method of transferring evidence into clinical practice (25). However, there is a potential risk of "information overload" if clinicians presented all of the key messages recommended by clinical guidelines to patients.…”

Section: Discussionmentioning

confidence: 99%

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

French

Bennell

Nicolson

et al. 2015

Arthritis Care & Research

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Objective. To establish priority key messages for patients with osteoarthritis (OA). Methods. A Delphi survey and priority pairwise ranking activity was conducted. Participants included 51 OA experts from 13 countries and 9 patients (consumers) living with hip and/or knee OA. During 3 Delphi rounds, the panel of experts and consumers rated recommendations extracted from clinical guidelines and provided additional statements they considered important. When ‡70% of panel members agreed a statement was "essential," it was retained for the next Delphi round. The final list of essential statements was reviewed by a consumer focus group and statements were modified for clarity if required. Finally, a priority pairwise ranking activity determined the rank order of the list of essential messages. Results. Eighty-five experts and 15 consumers were invited to participate; 51 experts and 9 consumers completed round 1 of the Delphi survey, and 43 experts and 8 consumers completed the final priority ranking activity. From an original list of 114 statements, 21 statements were rated as essential. Most statements (n 5 17) related to nondrug treatment approaches for OA. Study limitations included that >50% of the panel comprised of physical therapists lead to high rankings of exercise and physical activity statements and also that only English-language statements were considered. Conclusion. OA experts and consumers have identified and prioritized 21 key patient messages about OA. These messages may be used to inform the content of consumer educational materials to ensure patients are educated about the most important aspects of OA and its management.

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Section: Discussionmentioning

confidence: 99%

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

French

Bennell

Nicolson

et al. 2015

Arthritis Care & Research

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“…To our knowledge, no other study has systematically addressed the ways in which stakeholders' research priorities, and those of patients in particular, may change over time. Other research has explored how patients' health‐care priorities and value systems may change as a consequence of new medical diagnoses and/or multimorbidity. In the area of public deliberation, the views of citizens' jury participants may be influenced by their jury experience, and in one study, these views were retained upon questionnaire several weeks later .…”

Section: Discussionmentioning

confidence: 99%

Long‐term views on chronic kidney disease research priorities among stakeholders engaged in a priority‐setting partnership: A qualitative study

Elliott

Sale

Goodarzi

et al. 2018

Health Expectations

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BackgroundPatients and stakeholders are increasingly engaging in health research to help address evidence‐practice gaps and improve health‐care delivery. We previously engaged patients, caregivers, health‐care providers (HCPs) and policymakers in identifying priorities for chronic kidney disease (CKD) research.ObjectiveWe aimed to explore participants' views on the research priorities and prioritization process 2 years after the exercise took place.DesignIn this qualitative descriptive study, individual interviews were conducted and analysed using an inductive, thematic analysis approach.Setting/participantsParticipants resided across Canada. We purposively sampled across stakeholder groups (CKD patients, caregivers, HCPs and policymakers) and types of engagement (wiki, workshop and/or steering committee) from the previous CKD priority‐setting project.ResultsAcross 23 interviews, participants discussed their research priorities over time, views on the prioritization process and perceived applicability of the priorities. Even though their individual priorities may have changed, participants remained in agreement overall with the previously identified priorities, and some perceived a distinction between patient and HCP priorities. They tended to balance individual priorities with their broader potential impact and viewed the prioritization process as systematic, collaborative and legitimate. However, participants acknowledged challenges to applying the priorities and emphasized the importance of communicating the project's outcomes upon its completion.ConclusionTwo years after engaging in CKD research prioritization, stakeholder participants remained in agreement with the previously identified priorities, which they felt reflected group deliberation and consensus. Rapport and communication were highlighted as key elements supporting effective engagement in research prioritization.

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“…Increasingly, the notion of shared decision-making is coming into use as a model for understanding and improving the role of the patient in clinical decision-making [53]. Yet some have argued that the extent to which patients engage meaningfully in conversations about their medical care is not well understood [26] and that clinicians and patients may have differing opinions in relation to priorities and treatment [54]. For example, Brody has argued that the traditional model of patient-provider relationship places patients in a passive role that does not empower them to engage in clinical decision-making.…”

Section: Discussionmentioning

confidence: 99%

Where is the patient in models of patient-centred care: a grounded theory study of total joint replacement patients

Webster

Perruccio

Jenkinson

et al. 2013

BMC Health Serv Res

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BackgroundPatient-centered care ideally considers patient preferences, values and needs. However, it is unclear if policies such as wait time strategies for hip and knee replacement surgery (TJR) are patient-centred as they focus on an isolated episode of care. This paper describes the accounts of people scheduled to undergo TJR, focusing on their experience of (OA) as a chronic disease that has considerable impact on their everyday lives.MethodsSemi-structured qualitative interviews were conducted with participants scheduled to undergo TJR who were recruited from the practices of two orthopaedic surgeons. We first used maximum variation and then theoretical sampling based on age, sex and joint replaced. 33 participants (age 38-79 years; 17 female) were included in the analysis. 20 were scheduled for hip replacement and 13 for knee replacement. A constructivist approach to grounded theory guided sampling, data collection and analysis.ResultsWhile a specific hip or knee was the target for surgery, individuals experienced multiple-joint symptoms and comorbidities. Management of their health and daily lives was impacted by these combined experiences. Over time, they struggled to manage symptoms with varying degrees of access to and acceptance of pain medication, which was a source of constant concern. This was a multi-faceted issue with physicians reluctant to prescribe and many patients reluctant to take prescription pain medications due to their side effects.ConclusionsFor patients, TJR surgery is an acute intervention in the experience of chronic disease, OA and other comorbidities. While policy has focused on wait time as patient/surgeon decision for surgery to surgery date, the patient’s experience does not begin or end with surgery as they struggle to manage their pain. Our findings suggest that further work is needed to align the medical treatment of OA with the current policy emphasis on patient-centeredness. Patient-centred care may require a paradigm shift that is not always evident in current policy and strategies.

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Patient Priorities in Osteoarthritis and Comorbid Conditions: A Secondary Analysis of Qualitative Data

Cited by 35 publications

References 43 publications

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

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

Long‐term views on chronic kidney disease research priorities among stakeholders engaged in a priority‐setting partnership: A qualitative study

Where is the patient in models of patient-centred care: a grounded theory study of total joint replacement patients

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