Author:
Arslan Ilgin G.,van Berkel A. C.,Damen J.,Bindels P.,de Wilde M.,Bierma-Zeinstra S. M.A.,Schiphof D.
Abstract
Abstract
Objective
This study determined patterns of knee osteoarthritis (OA) management by general practitioners (GPs) using routine healthcare data from Dutch general practices from 2011 to 2019.
Design
A retrospective cohort study was conducted using the Integrated Primary Care Information database between 2011 and 2019. Electronic health records (EHRs) of n = 750 randomly selected knee OA patients (with either codified or narrative diagnosis) were reviewed against eligibility criteria and n = 503 patients were included. Recorded information was extracted on GPs’ management from six months before to three years after diagnosis and patterns of management were analysed.
Results
An X-ray referral was the most widely recorded management modality (63.2%). The next most widely recorded management modalities were a referral to secondary care (56.1%) and medication prescription or advice (48.3%). Records of recommendation of/referral to other primary care practitioners (e.g. physiotherapists) were found in only one third of the patients. Advice to lose weight was least common (1.2%). Records of medication prescriptions or recommendation of/referral to other primary care practitioners were found more frequently in patients with an X-ray referral compared to patients without, while records of secondary care referrals were found less frequently. Records of an X-ray referral were often found in narratively diagnosed knee OA patients before GPs recorded a code for knee OA in their EHR.
Conclusion
These findings emphasize the importance of better implementing non-surgical management of knee OA in general practice and on initiatives for reducing the overuse of X-rays for diagnosing knee OA in general practice.
Publisher
Springer Science and Business Media LLC
Reference42 articles.
1. World Health Organization. Musculoskeletal conditions: WHO. ; 2020 [21-02-2020]. Available from: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions.
2. Hunter DJ, Bierma-Zeinstra S, Osteoarthritis. Lancet. 2019;393(10182):1745–59.
3. Osteoarthritis Research Society International. Osteoarthritis: A Serious Disease. 2016:p. 103.
4. Dutch National Institute for Public Health and the Environment (RIVM). Prevalence and number of new cases of osteoarthritis in general practice 2021 [12-08-2021]. Available from: https://www.volksgezondheidenzorg.info/onderwerp/artrose/cijfers-context/huidige-situatie#node-prevalentie-en-aantal-nieuwe-gevallen-van-artrose-huisartsenpraktijk.
5. Arslan IG, Damen J, de Wilde M, JvdD J, Bindels PJE, van der Lei J et al. Under-recording of knee osteoarthritis: a population-based study with electronic health records in general practice. Submitted. 2021.