Joint and soft tissue injections in the community: questionnaire survey of general practitioners' experiences and attitudes

Gormley, Gerard; Corrigan, Matthew J.; Steele, W K; Stevenson, M; Taggart, A J

doi:10.1136/ard.62.1.61

Cited by 35 publications

(42 citation statements)

References 8 publications

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“…[3][4][5][6] In a recent survey of joint injection practices amongst GPs, shoulder injections were the commonest type of injection performed in the community. 7 Procedures carried out by GPs in the community have also been shown to be cost effective and popular with patients. 8 Training using shoulder mannequins is the most commonly used teaching method.…”

mentioning

confidence: 99%

“…7 A considerable number of GPs trained by this method do not currently perform injections on patients. 7 A minority of GPs have trained on patients, and there is a significant correlation between this teaching method and current injection activity. 7 This study aimed at evaluating the impact of two different methods of shoulder injection training on the reported number of injections performed by GPs and their level of confidence in carrying them out.…”

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confidence: 99%

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A randomised study of two training programmes for general practitioners in the techniques of shoulder injection

Gormley

2003

Annals of the Rheumatic Diseases

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A randomised study of two training programmes for general practitioners in the techniques of shoulder injection

Gormley

2003

Annals of the Rheumatic Diseases

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“…8 Confidence in treating musculoskeletal disorders is associated with postgraduate continuing medical education; 9 GPs prefer training with real patients and are more likely to perform injections if trained in this way. 10,11 There are many clinical diagnostic categories described for shoulder joint dysfunction based on the pattern of pain, range of movement, findings on resisted movement and specific clinical tests of shoulder function. Diagnoses include capsulitis, frozen shoulder, rotator cuff tendonitis, and subacromial bursitis amongst others.…”

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A survey of general practitioners' assessment and management of shoulder pain: training and practice

Ryans¹,

McKane

McCann

et al. 2009

International Musculoskeletal Medicine

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Introduction: Weaknesses in training of general practitioners (GPs) in musculoskeletal care have been identified. Little is known about methods of training GPs in shoulder pain management or the assessments they use in clinical practice. The aim of this study was to assess the effect of training methods in shoulder pain management on GPs' clinical practice. Methods: A validated, self-administered postal questionnaire on dealing with shoulder pain was sent to 1081 GPs. Results: Response rate was 48% (n = 520). The majority (82%) identified training at postgraduate meetings, 17% had attended clinics and 11% attended musculoskeletal courses. Practitioners who had been trained at clinics (odds ratio [OR] 17.5) and musculoskeletal courses (OR 8.2) were likely to perform injections. Similarly, GPs' confidence in shoulder examination was related to their attendance at clinics (P = 0.019) and musculoskeletal courses (P < 0.001) but not postgraduate meetings. In their clinical examination, GPs found that assessing the active range of movement (ROM), passive ROM and painful arc were the most useful clinical findings and they found corticosteroid injection, NSAIDs and physiotherapy equally effective in treatment and each more effective than doing nothing. Conclusions: General practitioners' confidence in assessment of shoulder pain and their likelihood of performing injections was increased by training either at a clinic or specific musculoskeletal course but not by simply attending postgraduate meetings. They found the most useful methods of assessment to be range of movement and painful arc, and considered injection, physiotherapy and NSAIDs as equally effective.

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“…23 A síntese dos estudos transversais que avaliaram aplicação de questionários a médicos de MGF acerca do tema das infiltrações de corticosteróides no tratamento de patologia músculo-esquelética encontra-se na Tabela 3. [24][25][26] Um estudo mostra que 164 médicos de MGF (66,4%) utilizavam a infiltração peri-articular de corticosteróides na sua prática clínica.…”

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“…26 A maioria dos médicos de MGF (73%) treinou em modelos, sendo o treino em doentes reais o que maior nível de confiança proporciona aos clínicos.…”

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Infiltração Peri-Articular de Corticosteróides na Abordagem da Patologia Músculo- Esquelética em Medicina Geral e Familiar: Uma Revisão Sistemática

Trindade¹

2015

Acta Med Port

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Introduction: Periarticular corticosteroid injection utilization by General Practitioners treating musculoskeletal disease in primary health care system is internationally acknowledged. This article aims at analyzing this evidence and contributing to the discussion of a potential development of the technique in Portugal. Material and Methods: Qualitative analysis of randomized control trials, cost-effectiveness studies, cross-sectional studies, retrospective cohort studies and observational studies, using PRISMA model. Data Sources: PubMed, Cochrane Library and Essential Evidence Plus. Eligibility criteria: corticosteroid injection mention in the treatment of musculoskeletal disease and an element that indicates primary health care context. Results: Nine randomized control trials, three cost-effectiveness studies, three cross-sectional studies, three descriptive studies and one retrospective cohort study were reviewed. Most success parameters of corticosteroid injections performed by general practitioners showed short term efficacy; at long term they did not outstand other therapeutic options. The balance between the economic burden ascribed to this technique utilization in primary health care context and gain in subject's quality of life is favorable. The eleven studies assessing security registered only minor side effects and no serious ones. Discussion: The periarticular corticosteroid injection technique performance places it as a therapeutic option treating musculoskeletal disease in Portuguese primary health care. Nevertheless further evidence is required to support its efficacy and safety parameters, namely at national level. Conclusion: Corticosteroid injection utilization in primary health care constitutes an effective and safe option, with the potential to improve primary health care service rendering in an economically sustainable way.

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Joint and soft tissue injections in the community: questionnaire survey of general practitioners' experiences and attitudes

Cited by 35 publications

References 8 publications

A randomised study of two training programmes for general practitioners in the techniques of shoulder injection

A randomised study of two training programmes for general practitioners in the techniques of shoulder injection

A survey of general practitioners' assessment and management of shoulder pain: training and practice

Infiltração Peri-Articular de Corticosteróides na Abordagem da Patologia Músculo- Esquelética em Medicina Geral e Familiar: Uma Revisão Sistemática

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