Power J Denise, Cott Cheryl A, Badley Elizabeth M, Hawker Gillian A
Arthritis Community Research and Evaluation Unit (ACREU), Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada.
J Rheumatol. 2005 Jan;32(1):123-9.
Physical therapy (PT) is a recommended treatment for the management of arthritis. We investigated factors related to referral to PT services in people with hip or knee arthritis and describe characteristics of treatment received.
As part of a longitudinal study of the population aged > or = 55 years with at least moderately severe hip or knee arthritis in 2 Ontario counties (n = 1350), participants were surveyed in the third year of followup about use of PT. Participants were categorized as to whether they had total joint replacement surgery in the past year (TJR group, n = 52) or did not (non-TJR group, n = 1298). Multivariate logistic regression was used to identify determinants of referral to PT considering sociodemographic characteristics, comorbidity, use of prescribed arthritis medication, and arthritis severity (WOMAC summary score).
Overall, 18.7% of the cohort was referred to PT in the past year: 65.4% of the TJR group and 16.8% of the non-TJR group. The only significant predictor of PT in the TJR group was current use of prescribed arthritis medication. Greater arthritis severity, current use of prescribed arthritis medication, and greater comorbidity were significant independent predictors of referral to PT for the non-TJR group in multivariate logistic regression. The Ontario Health Insurance Plan paid for the majority of PT received.
Low rates of referral to PT in the previous year suggest possible underutilization. Further research is needed to examine patterns of use of PT throughout the course of the arthritis disease process and to examine barriers to PT access.
物理治疗（PT）是推荐用于关节炎管理的一种治疗方法。我们调查了髋或膝关节炎患者转诊至PT服务的相关因素，并描述了所接受治疗的特征。
作为对安大略省两个县中年龄≥55岁且患有至少中度严重髋或膝关节炎的人群进行的纵向研究的一部分（n = 1350），在随访的第三年对参与者进行了关于PT使用情况的调查。参与者被分类为过去一年是否进行了全关节置换手术（TJR组，n = 52）或未进行（非TJR组，n = 1298）。使用多变量逻辑回归来确定转诊至PT的决定因素，同时考虑社会人口学特征、合并症、处方关节炎药物的使用以及关节炎严重程度（WOMAC总分）。
总体而言，该队列中有18.7%的人在过去一年被转诊至PT：TJR组为65.4%，非TJR组为16.8%。TJR组中PT的唯一显著预测因素是当前使用处方关节炎药物。在多变量逻辑回归中，关节炎严重程度更高、当前使用处方关节炎药物以及合并症更多是转诊至PT的非TJR组的显著独立预测因素。安大略省健康保险计划支付了大部分接受的PT费用。
前一年转诊至PT的比例较低表明可能存在利用不足的情况。需要进一步研究以检查在整个关节炎疾病过程中PT的使用模式，并检查获得PT服务的障碍。
