Arthritis Research Centre of Canada, 895 West 10th Ave., Room 324, Vancouver, British Columbia V5Z 1L7, Canada.
J Rheumatol. 2011 Oct;38(10):2230-7. doi: 10.3899/jrheum.110264. Epub 2011 Aug 1.
To assess the quality of nonpharmacological care received by people with knee and/or hip osteoarthritis (OA) in the community and to assess the associated factors.
We conducted a postal survey to evaluate 4 OA quality-of-care indicators for knee/hip OA: (1) advice to exercise; (2) advice to lose weight; (3) assessment for ambulatory function; and (4) assessment for nonambulatory function, including dressing, grooming, and arising from a seated position. Eligible participants were identified from the administrative database of British Columbia between 1992 and 2006.
In total, 1349 participants reported knee and/or hip OA [knee only = 700 (51.9%); hip only = 261 (19.3%); knee and hip = 388 (28.8%)]. Their mean age was 67.1 years (SD 11.1); 816 (60.5%) were women, and 921 (68.3%) were diagnosed with OA for 6 years or longer. The overall pass rate of the 4 quality indicators was 22.4% (95% CI 20.5, 24.3). The pass rate for the individual quality indicator ranged from 6.9% for assessment of nonambulatory function to 29.2% for receiving assessment of ambulatory function. Receiving exercise advice was associated with having a university degree (vs high school diploma; OR 3.10, 95% CI 2.00, 4.80). Receiving weight-loss advice was associated with being female (OR 2.64, 95% CI 1.71, 4.08), being aged 55-64 years (compared to being aged 75 and over; OR 1.96, 95% CI 1.02, 3.76), and having higher Western Ontario and McMaster Universities Osteoarthritis Index scores (for every 10-point increment; OR 1.14, 95% CI 1.02, 1.26). On the other hand, having less than a high school education reduced the odds of weight-loss advice (OR 0.52, 95% CI 0.30, 0.88).
The quality of nonpharmacological care for people with knee/hip OA in the community is suboptimal. Advice on exercise and weight management may not be provided equally across sex, age, disability, and formal education levels.
评估社区中膝和/或髋骨骨关节炎（OA）患者接受的非药物护理质量，并评估相关因素。
我们进行了一项邮政调查，以评估 4 个 OA 护理质量指标：（1）运动建议；（2）减肥建议；（3）步行功能评估；（4）非步行功能评估，包括穿衣、修饰和从坐姿起身。1992 年至 2006 年间，从不列颠哥伦比亚省的行政数据库中确定了符合条件的参与者。
共有 1349 名参与者报告了膝和/或髋 OA [仅膝=700（51.9%）；仅髋=261（19.3%）；膝和髋=388（28.8%）]。他们的平均年龄为 67.1 岁（标准差 11.1）；816 名（60.5%）为女性，921 名（68.3%）诊断 OA 时间在 6 年或以上。4 项质量指标的总体通过率为 22.4%（95%CI 20.5，24.3）。单个质量指标的通过率范围为 6.9%的非步行功能评估至 29.2%的步行功能评估。接受运动建议与拥有大学学位（与高中文凭相比；OR 3.10，95%CI 2.00，4.80）有关。接受减肥建议与女性（OR 2.64，95%CI 1.71，4.08）、年龄 55-64 岁（与年龄 75 岁及以上相比；OR 1.96，95%CI 1.02，3.76）和更高的西安大略大学和麦克马斯特大学骨关节炎指数评分（每增加 10 分；OR 1.14，95%CI 1.02，1.26）有关。另一方面，接受的教育程度低于高中会降低获得减肥建议的可能性（OR 0.52，95%CI 0.30，0.88）。
社区中膝/髋 OA 患者的非药物护理质量不理想。关于运动和体重管理的建议可能没有在性别、年龄、残疾和正规教育程度方面平等提供。
