Health care provision for osteoarthritis: concordance between what patients would like and what health professionals think they should have.

ABSTRACT

OBJECTIVE: To explore the opinions of patients and health professionals about the provision of health care for people with osteoarthritis (OA) and possible service improvements. METHODS: Qualitative methods were used to explore the opinions of patients and health professionals about existing OA care and possible changes in service provision. Sixteen patients with hip or knee OA took part in focus groups, and 12 health professionals from primary and secondary care were interviewed. Focus groups and interviews were audio-recorded, transcribed, and anonymized. Transcripts were analyzed using the Framework method. RESULTS: The views of the patients and health professionals generally concurred. They felt that OA should receive more attention and better consistency of care. More information and education about the condition, diet, exercise, aids, and resources was needed at the time of diagnosis. Patients wanted more time, better continuity, and proactive followup from general practitioners, with less variation in accessing joint replacement. Participants suggested access on demand to an "OA specialist" in primary care and the use of a management model comparable to other long-term conditions. Both patients and health professionals wanted better support for self-management to help patients manage their condition more effectively and appropriately. CONCLUSION: Patients and health professionals perceived similar problems with OA care. More proactive care and improved information, especially for those with early OA, might achieve better outcomes. Access to a primary care OA specialist might provide better continuity of care, enable patients to meet their needs for information, support, and self-management, as well as improve appropriate referral to other resources.