Self-reported quality care for knee osteoarthritis: comparisons across Denmark, Norway, Portugal and the UK

Abstract

ObjectivesTo assess and compare patient perceived quality of osteoarthritis (OA) management in primary healthcare in Denmark, Norway, Portugal and the UK.MethodsParticipants consulting with clinical signs and symptoms of knee OA were identified in 30 general practices and invited to complete a cross-sectional survey including quality indicators (QI) for OA care. A QI was considered as eligible if the participant had checked ‘Yes’ or ‘No’, and as achieved if the participant had checked ‘Yes’ to the indicator. The median percentage (with IQR and range) of eligible QIs achieved by country was determined and compared in negative binominal regression analysis. Achievement of individual QIs by country was determined and compared using logistic regression analyses.ResultsA total of 354 participants self-reported QI achievement. The median percentage of eligible QIs achieved (checked ‘Yes’) was 48% (IQR 28%, 64%; range 0–100%) for the total sample with relatively similar medians across three of four countries. Achievement rates on individual QIs showed a large variation ranging from 11% (referral to services for losing weight) to 67% (information about the importance of exercise) with significant differences in achievement rates between the countries.ConclusionsThe results indicated a potential for improvement in OA care in all four countries, but for somewhat different aspects of OA care. By exploring these differences and comparing healthcare services, ideas may be generated on how the quality might be improved across nations. Larger studies are needed to confirm and further explore the findings.

Physical Activity Intervention in Primary Care and Rheumatology for the Management of Knee Osteoarthritis: A Review

“…Eight studies described the practice of PCPs, including 1 study that also described rheumatology practice ; an additional 3 studies described rheumatology practice . Different methodologies were used, including patient self‐report by questionnaire , physician self‐report by questionnaire or in response to specific patient case scenarios , or chart review . Details of these studies are provided in Table .…”

“…Together, these studies provide data on 7 countries. Across 5 European countries 49–83% of patients reported having been provided with information about exercise from their PCP . Additional studies in France and the UK found that 9–87% of PCPs said they would recommend exercise, based on case scenarios .…”

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“…chiropractor, acupuncture, osteopath, laser therapist, massage therapist, personal trainer) 2 (2) 11 (14) 11 (23) 9 (36) 31 (29) Arthritis educator -8 (10) 5 (11) -13 (12) Note: Visit order for first four reported health professionals only. For second, third and fourth visits, percentages calculated using the total number of participants in each column as the denominator education about physical activity, which is similar to the OA-QI achievement rate in previous studies (Grønhaug et al, 2015(Grønhaug et al, , 2014Østerås et al, 2015;Østerås et al, 2013). This is in keeping with clinical guidelines that advocate for the promotion of physical activity for all people with hip and knee OA (Department of Veterans Affairs, & Department of Defense, 2014; Loew et al, 2012;National Institute for Health and Care Excellence, 2015;Zhang et al, 2008).…”

“…However, in our study, less than half of participants surveyed had been provided with a referral for physical activity management, supporting the need for improved multi-disciplinary management in New Zealand. The achievement rates for pharmacological interventions (recommended Paracetamol as first medication [80%] and information about anti-inflammatory side-effects [72%]) were higher than identified in previous research, suggesting that pharmacological interventions for OA may be more popular in New Zealand than in other countries (Grønhaug et al, 2014;Østerås et al, 2015;Østerås et al, 2013).…”

Pakkeforløp for pasienter med muskel- og skjelettplager?

“…Førstelinjebehandling for pasienter med kne-og hofteartrose er informasjon (artroseskole), veiledet trening og eventuelt vektreduksjon (6). Altfor få pasienter som kontakter primaerhelsetjenesten med artroseplager, blir tilbudt adekvat behandling (7,8). Noen får beskjed om at det ikke er noe å gjøre med, andre blir henvist til MR-undersøkelse og videre til spesialisthelsetjenesten uten å ha blitt skikkelig undersøkt eller fått tilbud om kunnskapsbasert behandling i primaerhelsetjenesten.…”