Wallis Jason A, Barton Christian J, Ackerman Ilana N, Sherwood James, Kemp Joanne L, Young Kirby, Jennings Sophie, Trivett Adrian, Brusco Natasha K
Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Melbourne, Victoria, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Musculoskeletal Care. 2023 Mar;21(1):272-282. doi: 10.1002/msc.1698. Epub 2022 Sep 13.
Strategies are needed to improve referral into, and uptake of, osteoarthritis (OA) management programs. This survey investigated and compared patients' and medical professionals' views around hip and knee OA management and factors impacting implementation of an osteoarthritis management program.
As part of a mixed-methods program of research, patients with hip or knee OA and medical professionals routinely involved in the management of OA, were invited to complete a comprehensive online survey. All data were analysed descriptively or using chi squared tests. Survey findings for factors perceived to impact implementation of an OA management programme were triangulated with previously reported qualitative data.
Fifty-three patients (38 females, 15 males) and 32 medical professionals (orthopaedic surgeons, sports physicians, rehabilitation physicians, rheumatologists and general practitioners) completed the survey. Twenty-eight patients (53%) had prior participation in the OA management programme (GLA:D ) and 19 medical professionals (59%) had previously referred patients to the programme. Of the participants with prior exposure, 21 patients (75%) and 15 medical professionals (79%) agreed the programme was beneficial. A higher proportion of medical professionals, compared to patients, believed weight loss (100% vs. 67%), injection therapy (50% vs. 21%), hip replacement (100% vs. 62%) and knee replacement (97% vs. 62%) were effective treatments, with no differences for all other treatments. The barriers and enablers identified for referral into, and participation in, an OA management programme mostly aligned to factors identified in previous related qualitative research. Divergent factors in the survey included patients concerns about doing exercise-therapy with 81% (higher than expected) not reporting any concerns about exercising, and 19% (lower than expected) concerned about their OA joint, such as making their pain worse.
This study has extended our understanding of barriers and enablers for referral into, and participation in, an OA management programme with a lower than expected number of patients being concerned about exercising due to their OA joint. Patients and medical professionals had positive views relating to the quality of the programme delivery, patient satisfaction and programme effectiveness. Medical professionals were more likely than patients to consider weight loss, injections and joint replacement as effective treatment options.
需要采取策略来改善骨关节炎（OA）管理项目的转诊及参与情况。本调查研究并比较了患者和医学专业人员对髋膝关节OA管理的看法以及影响骨关节炎管理项目实施的因素。
作为一项混合方法研究项目的一部分，邀请髋或膝关节OA患者以及常规参与OA管理的医学专业人员完成一项全面的在线调查。所有数据采用描述性分析或卡方检验进行分析。将被认为影响OA管理项目实施的因素的调查结果与先前报告的定性数据进行三角互证。
53名患者（38名女性，15名男性）和32名医学专业人员（骨科医生、运动医学医生、康复医生、风湿病学家和全科医生）完成了调查。28名患者（53%）曾参与OA管理项目（GLA:D），19名医学专业人员（59%）曾将患者转诊至该项目。在有过参与经历的参与者中，21名患者（75%）和15名医学专业人员（79%）认为该项目有益。与患者相比，更高比例的医学专业人员认为减肥（100%对67%）、注射治疗（50%对21%）、髋关节置换（100%对62%）和膝关节置换（97%对62%）是有效的治疗方法，而对于所有其他治疗方法则没有差异。确定的转诊至OA管理项目及参与该项目的障碍和促进因素大多与先前相关定性研究中确定的因素一致。调查中的不同因素包括患者对进行运动疗法的担忧，81%（高于预期）的患者表示对运动没有任何担忧，19%（低于预期）的患者担心其OA关节，如使疼痛加重。
本研究扩展了我们对转诊至OA管理项目及参与该项目的障碍和促进因素的理解，因OA关节而担心运动的患者数量低于预期。患者和医学专业人员对项目实施质量、患者满意度和项目有效性持积极看法。医学专业人员比患者更有可能认为减肥、注射和关节置换是有效的治疗选择。
