Physiotherapists’ experiences of osteoarthritis guidelines in primary health care – an interview study

Abstract

Background Osteoarthritis is a common joint disease, globally. Guidelines recommend information, exercise and, if needed, weight reduction as core treatment. There is a gap between evidence-based recommended care for osteoarthritis and clinical practice. To increase compliance to guidelines, implementation was conducted. The aim of the study was to explore physiotherapists’ experiences of osteoarthritis guidelines and their experiences of implementation of the guidelines in primary health care in a region in southern Sweden. Methods Eighteen individual, semi-structured interviews with physiotherapists in primary health care were analysed with inductive qualitative content analysis. Results The analysis resulted in two categories and four subcategories. The physiotherapists were confident in their role as primary assessors for patients with osteoarthritis and the guidelines were aligned with their professional beliefs. The Supported Osteoarthritis Self-Management Programme, that is part of the guidelines, was found to be efficient for the patients. Even though the physiotherapists followed the guidelines they saw room for improvement since all patients with hip and/or knee osteoarthritis did not receive treatment according to the guidelines. Furthermore, the physiotherapists emphasised the need for management’s support and that guidelines should be easy to follow. Conclusion The physiotherapists believed in the guidelines and were confident in providing first line treatment to patients with osteoarthritis. However, information about the guidelines probably needs to be repeated to all health care providers and management. Data from a national quality register on osteoarthritis could be used to a greater extent in daily clinical work in primary health care to improve quality of care for patients with osteoarthritis.

Barriers and facilitators of integrating physiotherapy into primary health care settings: A systematic scoping review of qualitative research

“…After removing duplicates, 483 studies were screened. Next, 138 studies were evaluated based on their full text, and in the end, 44 qualitative studies [ 7 , 16 , 20 , 23 , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] ] were included in the study. Fig.…”

“…This systematic review included 44 qualitative studies conducted in 14 countries, mostly high-income countries: United Kingdom (27.2 %, n = 12) [ 34 , 36 , 39 , 47 , 49 , 52 , 58 , 62 , [64] , [65] , [66] , [67] ], Sweden (13.6 %, n = 6) [ 38 , 43 , 53 , 54 , 59 , 63 ], Ireland (11.3 %, n = 5) [ 32 , 35 , 40 , 44 , 48 ], Canada (11.3 %, n = 5) [ 7 , 20 , 23 , 37 , 68 ], the Netherlands (9.1 %, n = 4) [ 31 , 42 , 46 , 50 ], Norway (6.8 %, n = 3) [ 33 , 41 , 61 ], South Africa (4.5 %, n = 2) [ 60 , 69 ], Brazil (2.2 %, n = 1) [ 16 ], Chile (2.2 %, n = 1) [ 45 ], Germany (2.2 %, n = 1) [ 56 ], Iran (2.2 %, n = 1) [ 51 ], Spain (2.2 %, n = 1) [ 55 ], Australia (2.2 %, n = 1) [ 70 ], and multiple-countries (2.2 %, n = 1) [ 57 ]. Semi-structured interviews, focus group sessions, or both of them were the common data collection methods, respectively.…”

Enablement And Empowerment Among Patients Participating In A Supported Osteoarthritis Self-Management Programme - A Prospective Observational Study

“…Therefore, some patients might have had their diagnosis for some time, sometimes many years, before participating in SOASP. Reasons for that might vary (patients not wanting to see at PT before, patients not being referred to at PT but to a doctor, all health care professionals not following the guidelines and so on) [42]. This delay in participation in SOASP would affect patients´ adaptation, understanding and coping with their illness and that would impact on their PEI score and their enablement.…”

Effect of exercise and/or educational interventions on physical activity and pain in patients with hip/knee osteoarthritis: A systematic review with meta-analysis

“…Exercise therapy and/or educational intervention is recommended as the first-line treatment for hip or knee OA [ 15 – 19 ]. However, previous meta-analyses have reported that high-intensity exercise and educational intervention did not improve long-term physical activity in patients with hip or knee OA [ 20 , 21 ].…”