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Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study

BACKGROUND: A multidisciplinary, guideline-based Stepped-Care-Strategy (SCS), has recently been developed to improve the management of hip and knee osteoarthritis (OA). To date, it is unknown to what extent current Dutch OA care is consistent with the SCS, both with respect to the content of care as...

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Autores principales: Barten, Di-Janne JA, Swinkels, llse CS, Dorsman, Sara A, Dekker, Joost, Veenhof, Cindy, de Bakker, Dinny H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483212/
https://www.ncbi.nlm.nih.gov/pubmed/26116374
http://dx.doi.org/10.1186/s12875-015-0295-9
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author Barten, Di-Janne JA
Swinkels, llse CS
Dorsman, Sara A
Dekker, Joost
Veenhof, Cindy
de Bakker, Dinny H
author_facet Barten, Di-Janne JA
Swinkels, llse CS
Dorsman, Sara A
Dekker, Joost
Veenhof, Cindy
de Bakker, Dinny H
author_sort Barten, Di-Janne JA
collection PubMed
description BACKGROUND: A multidisciplinary, guideline-based Stepped-Care-Strategy (SCS), has recently been developed to improve the management of hip and knee osteoarthritis (OA). To date, it is unknown to what extent current Dutch OA care is consistent with the SCS, both with respect to the content of care as well as the sequence of care. Furthermore, there is a lack of clarity regarding the role of different health care providers in the performance of OA care according to the SCS. Therefore, the main purpose of this study is to describe the content of primary care in patients with hip/knee OA, including the compliance to the SCS and taking into account the introduction of patient self-referral to physical therapy. METHODS: Data were used from NIVEL Primary Care Database. In total, 12.118 patients with hip/knee OA who visited their GP or physical therapist were selected. Descriptive statistics were used to compare the content of care in GP-referred and self-referred patients to physical therapy. RESULTS: Content of care performed by GPs mostly concerned consultations, followed by NSAID prescriptions and referrals to secondary care. Both prescriptions of acetaminophen and referrals to physical therapy respectively dietary therapy were rarely mentioned. Nevertheless, still 65% of the patients in physical therapy practice were referred by their GP. Compared to GP-referred patients, self-referred patients more often presented recurrent complaints and were treated less often by activity-related exercise therapy. Education was rarely registered as singular intervention, neither in GP-referred nor in self-referred patients. CONCLUSION: In accordance with the SCS, less advanced interventions are more often applied than more advanced interventions. To optimize the adherence to the SCS, GPs could reconsider the frequent use of NSAIDs instead of analgesics and the low referral rate to allied health care. Self-referral to physical therapy partially distorts both the low referral rate in general practice and the low application rate of education as singular intervention in physical therapy practice. Further research is recommended to evaluate the effects of task-shifting in OA care, taking into account the content of the SCS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12875-015-0295-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-44832122015-06-28 Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study Barten, Di-Janne JA Swinkels, llse CS Dorsman, Sara A Dekker, Joost Veenhof, Cindy de Bakker, Dinny H BMC Fam Pract Research Article BACKGROUND: A multidisciplinary, guideline-based Stepped-Care-Strategy (SCS), has recently been developed to improve the management of hip and knee osteoarthritis (OA). To date, it is unknown to what extent current Dutch OA care is consistent with the SCS, both with respect to the content of care as well as the sequence of care. Furthermore, there is a lack of clarity regarding the role of different health care providers in the performance of OA care according to the SCS. Therefore, the main purpose of this study is to describe the content of primary care in patients with hip/knee OA, including the compliance to the SCS and taking into account the introduction of patient self-referral to physical therapy. METHODS: Data were used from NIVEL Primary Care Database. In total, 12.118 patients with hip/knee OA who visited their GP or physical therapist were selected. Descriptive statistics were used to compare the content of care in GP-referred and self-referred patients to physical therapy. RESULTS: Content of care performed by GPs mostly concerned consultations, followed by NSAID prescriptions and referrals to secondary care. Both prescriptions of acetaminophen and referrals to physical therapy respectively dietary therapy were rarely mentioned. Nevertheless, still 65% of the patients in physical therapy practice were referred by their GP. Compared to GP-referred patients, self-referred patients more often presented recurrent complaints and were treated less often by activity-related exercise therapy. Education was rarely registered as singular intervention, neither in GP-referred nor in self-referred patients. CONCLUSION: In accordance with the SCS, less advanced interventions are more often applied than more advanced interventions. To optimize the adherence to the SCS, GPs could reconsider the frequent use of NSAIDs instead of analgesics and the low referral rate to allied health care. Self-referral to physical therapy partially distorts both the low referral rate in general practice and the low application rate of education as singular intervention in physical therapy practice. Further research is recommended to evaluate the effects of task-shifting in OA care, taking into account the content of the SCS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12875-015-0295-9) contains supplementary material, which is available to authorized users. BioMed Central 2015-06-27 /pmc/articles/PMC4483212/ /pubmed/26116374 http://dx.doi.org/10.1186/s12875-015-0295-9 Text en © Barten et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Barten, Di-Janne JA
Swinkels, llse CS
Dorsman, Sara A
Dekker, Joost
Veenhof, Cindy
de Bakker, Dinny H
Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study
title Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study
title_full Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study
title_fullStr Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study
title_full_unstemmed Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study
title_short Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study
title_sort treatment of hip/knee osteoarthritis in dutch general practice and physical therapy practice: an observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483212/
https://www.ncbi.nlm.nih.gov/pubmed/26116374
http://dx.doi.org/10.1186/s12875-015-0295-9
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