Patients' Perceptions of Navigating “The System” for Arthritis Management: Are They Able to Follow Our Recommendations?

Author:

Winter Di Cola Jennifer1,Juma Shahiroz23,Kennedy Deborah234,Dickson Patricia25,Denis Suzanne234,Robarts Susan2,Gollish Jeffrey26,Webster Fiona78

Affiliation:

1. Hospital for Sick Children, Toronto

2. Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre

3. Department of Physical Therapy

4. School of Rehabilitation Science, McMaster University, Hamilton, Ont.

5. Department of Occupational Science and Occupational Therapy

6. Department of Surgery

7. Department of Family and Community Medicine

8. Institute of Health Policy Management and Evaluation, University of Toronto, Toronto

Abstract

Purpose: To understand whether a visit to a Hip/Knee Arthritis Assessment Centre (AC), where non-surgical candidates with arthritis are directed toward community resources and provided with a conservative treatment “prescription,” contributes to patients' self-management and ability to access community resources. Methods: A purposive sample of non-surgical patients was contacted 3–10 months after their AC visit. Three focus groups (n=20) and 20 semi-structured telephone interviews were conducted. Transcripts were systematically coded and analyzed using a qualitative descriptive research methodology. Results: While participants generally reported that the AC visit improved self-management, analysis identified an emergent theme about the inadequacy of conservative management in general, subdivided into two sub-themes related to (1) limited access to high-quality, non-surgical treatment, such as physiotherapy and (2) health care providers' attitudes and approaches, which do not embrace chronic disease prevention and management. Conclusions: An AC visit contributes to arthritis self-management; however, the current health care system does not adequately support conservative treatment of chronic conditions. Treatment guidelines need to be tailored to the local health care context in which they are applied.

Publisher

University of Toronto Press Inc. (UTPress)

Subject

Physical Therapy, Sports Therapy and Rehabilitation

Reference37 articles.

1. Arthritis Alliance of Canada (2011).The impact of arthritis in Canada: today and over the next 30 years [Internet]. cited 2012 Sep 23Toronto: The AllianceAvailable from: http://www.arthritisalliance.ca/docs/20111022_2200_impact_of_arthritis.pdf

2. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study.

3. Canadian Institute for Health Information (2006).Hip and knee replacements in Canada—Canadian Joint Replacement Registry (CJRR) 2005–2006 annual report.Ottawa:CIHI

4. American Academy of Orthopaedic Surgeons Clinical Practice Guideline on The Treatment of Osteoarthritis (OA) of the Knee

5. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update

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