Management recommendations for knee osteoarthritis: How usable are they?
Summary of "Management recommendations for knee osteoarthritis: How usable are they?"
OBJECTIVES:
Despite the availability of practice guidelines for the management of knee osteoarthritis, inadequacies in practices of clinicians and patients have been found, leading to suboptimal outcomes. Literature has shown that simply disseminating management recommendations does not lead to adherence. Research suggests that barriers to use should be identified and addressed to improve adherence. The objective of this study was to identify barriers to use of conservative management recommendations for knee osteoarthritis by patients, general practitioners and physiotherapists.
METHODS:
Following systematic reviews of evidence and guidelines, 12 key management recommendations were elaborated on four themes: medication, exercise, self-management and occupation. Focus groups were separately done with patients with knee osteoarthritis, general practitioners and physiotherapists to assess barriers to the use of recommendations.
RESULTS:
Patients and general practitioners appeared generally fatalistic with regards to knee osteoarthritis, with physiotherapists being more positive regarding long-term improvement of knee osteoarthritis. For medication, discrepancies were found between recommendations and views of clinicians. Both patients and general practitioners appeared ambivalent towards exercise and activity, recognizing its usefulness but identifying it at the same time as a cause of knee osteoarthritis. Patients and general practitioners appeared to consider weight loss particularly difficult. DISCUSSION/
CONCLUSIONS:
Barriers specific to each knee osteoarthritis management recommendation and stakeholder group were identified. Recommendations to address these barriers were elaborated. Results of this study can be used to develop implementation strategies to overcome identified barriers, with the goal of facilitating the use of guideline recommendations and improving outcomes.
Affiliation
School of Rehabilitation, University of Ottawa, Ottawa, Canada.
Journal Details
This article was published in the following journal.
Name: Joint, bone, spine : revue du rhumatisme
ISSN: 1778-7254
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20851659
- DOI: http://dx.doi.org/10.1016/j.jbspin.2010.08.001
Medical and Biotech [MESH] Definitions
Osteoarthritis, Knee
Noninflammatory degenerative disease of the knee joint consisting of three large categories: conditions that block normal synchronous movement, conditions that produce abnormal pathways of motion, and conditions that cause stress concentration resulting in changes to articular cartilage. (Crenshaw, Campbell's Operative Orthopaedics, 8th ed, p2019)
Knee Injuries
Injuries to the knee or the knee joint.
Knee Prosthesis
Replacement for a knee joint.
Materials Management, Hospital
The management of all procurement, distribution, and storage of equipment and supplies, as well as logistics management including laundry, processing of reusables, etc.
Management Quality Circles
Participation of employees with management as a labor-management team, in decisions pertaining to the operational activities of the organization or industry.
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