Patients' and Practitioners' Views of Knee Osteoarthritis and Its Management: A Qualitative Interview Study

Abstract

PurposeTo identify the views of patients and care providers regarding the management of knee osteoarthritis (OA) and to reveal potential obstacles to improving health care strategies.MethodsWe performed a qualitative study based on semi-structured interviews of a stratified sample of 81 patients (59 women) and 29 practitioners (8 women, 11 general practitioners [GPs], 6 rheumatologists, 4 orthopedic surgeons, and 8 [4 GPs] delivering alternative medicine).ResultsTwo main domains of patient views were identified: one about the patient–physician relationship and the other about treatments. Patients feel that their complaints are not taken seriously. They also feel that practitioners act as technicians, paying more attention to the knee than to the individual, and they consider that not enough time is spent on information and counseling. They have negative perceptions of drugs and a feeling of medical uncertainty about OA, which leads to less compliance with treatment and a switch to alternative medicine. Patients believe that knee OA is an inevitable illness associated with age, that not much can be done to modify its evolution, that treatments are of little help, and that practitioners have not much to propose. They express unrealistic fears about the impact of knee OA on daily and social life. Practitioners' views differ from those of patients. Physicians emphasize the difficulty in elaborating treatment strategies and the need for a tool to help in treatment choice.ConclusionsThis qualitative study suggests several ways to improve the patient–practitioner relationship and the efficacy of treatment strategies, by increasing their acceptability and compliance. Providing adapted and formalized information to patients, adopting more global assessment and therapeutic approaches, and dealing more accurately with patients' paradoxal representation of drug therapy are main factors of improvement that should be addressed.

Balance, falls, and exercise: Beliefs and experiences in people with hemophilia: A qualitative study

“…The first and second authors then collaborated on the final version of a semi‐structured interview to address study questions. Qualitative methods were chosen to allow for a deeper understanding of the range of individual experiences, perceptions, expectations, beliefs, and fears around the area of interest 8, 25, 26. Adults with hemophilia who were patients at Bloodworks both with and without a positive fall history were identified by chart review and invited in person and by telephone to participate.…”

Knee health promotion option for knee osteoarthritis: A preliminary report of a concept of multidisciplinary management

“…According to a recent qualitative study [20], providing adapted and formalized information to patients, adopting greater global assessment and more therapeutic approaches, and dealing more accurately with patients' paradoxical representations of therapy are key ways to improve the patient-physician relationship and the efficacy of treatment strategies. Based on our research and understanding about the medial abrasion phenomenon as a cause of pain and disability in most knee OA patients [4][5][6][7][8], our formalized global management protocol could provide precise and adequate information for both patients and health care providers.…”

Why don’t patients take their analgesics? A meta-ethnography assessing the perceptions of medication adherence in patients with osteoarthritis

“…Of the five included studies, three were semi-structured interviews [18,19,21] and two were survey study designs [17,20]. Two studies were undertaken in Australia [17,18], one in Canada [19], one in France [21], whilst Blamey et al's [20] study was undertaken in the UK.…”

“…This included 404 participants from the two survey studies [17,20], and 115 participants who were sampled for the three semi-structured interview studies [18,19,21]. There were largely equal proportions of males and females represented in each study, with the exception being Alami et al [21] where 73 % of the cohort were female and Blamey et al [20] where 71 % were female. Mean age of the cohorts ranged from 55 years [20] to 62 years [17].…”

“…Whilst neither Milder et al [18] nor Blamey et al [20] signified the proportionality of the specific joints affected by osteoarthritis, this was documented in three papers. Participants in Laba et al [17] and Alami et al [21] presented with solely knee osteoarthritis whilst Sale et al's [19] cohort presented with hip and/ or knee osteoarthritis. The co-morbidities presented in each cohort were documents in three studies [17][18][19].…”