Papandony M C, Chou L, Seneviwickrama M, Cicuttini F M, Lasserre K, Teichtahl A J, Wang Y, Briggs A M, Wluka A E
Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
Monash University Library, Monash University, Melbourne, Victoria, Australia.
Osteoarthritis Cartilage. 2017 Jul;25(7):1010-1025. doi: 10.1016/j.joca.2017.02.799. Epub 2017 Feb 21.
To identify and synthesise evidence regarding patients' perceived health service needs related to osteoarthritis (OA).
A comprehensive systematic scoping review of MEDLINE, PsycINFO, EMBASE and CINAHL (1990-2016) was performed to capture information regarding patient perceived health service needs related to OA. Risk of bias and quality of included articles were assessed. Relevant data were extracted and collated to provide a systematic review of the existing literature.
Of the 1384 identified manuscripts, 21 were relevant to areas of patient perceived need, including needs related to medical care, pharmacologic therapy, physiotherapy and exercise therapy and alternative medicine. Key findings included (1) Symptom control drove the need for both conventional and complementary services. (2) An individualized relationship was sought with a practitioner knowledgeable in OA care and who adopted a holistic approach, whether providing conventional or alternative therapies. (3) Medications were required to obtain symptomatic relief, with use tempered by recognition of potential side effects and financial cost. (4) The need for allied health services was recognised, although patient and system issues were barriers to uptake. (5) Patient's attitudes towards joint replacement, orthoses and physical aids were influenced by patient preferences and previous healthcare experiences.
Patient perceived needs are similar to those suggested by clinical guideline recommendations. Better aligning patient perceived needs with healthcare requirements may improve OA outcomes and optimise healthcare system utilisation.
识别并综合有关患者对骨关节炎(OA)相关医疗服务需求的证据。
对MEDLINE、PsycINFO、EMBASE和CINAHL(1990 - 2016年)进行全面的系统综述,以获取有关患者对OA相关医疗服务需求的信息。评估纳入文章的偏倚风险和质量。提取并整理相关数据,以对现有文献进行系统综述。
在1384篇已识别的手稿中,21篇与患者感知需求领域相关,包括与医疗护理、药物治疗、物理治疗和运动疗法以及替代医学相关的需求。主要发现包括:(1)症状控制推动了对传统和补充服务的需求。(2)患者寻求与熟悉OA护理且采用整体方法的从业者建立个性化关系,无论其提供传统疗法还是替代疗法。(3)需要药物来缓解症状,但要考虑到潜在的副作用和经济成本。(4)认识到对联合健康服务的需求,尽管患者和系统问题是获取服务的障碍。(5)患者对关节置换、矫形器和辅助器具的态度受患者偏好和既往医疗经历影响。
患者感知的需求与临床指南建议的需求相似。使患者感知的需求与医疗保健要求更好地匹配可能会改善OA治疗效果并优化医疗系统的利用。