Background Based on a stepped-care management strategy for hip or knee osteoarthritis (OA)¹, the self-management booklet “Care for Osteoarthritis” was developed. The aim of this booklet is to enhance the patient’s active role in the treatment of OA and to improve communication with health care providers. Although patient booklets are a common strategy to enhance self-management, barriers and facilitators for patients to use such booklets are largely unknown.

Objectives To identify patient perceived barriers and facilitators to use the self-management booklet “Care for Osteoarthritis”.

Methods Seventeen patients with hip or knee OA who received the booklet participated in this qualitative study using semi-structured interviews. To ensure diversity of the patients’ view about the booklet, purposive sampling was used whereby we identified patients who used the booklet, who only read the booklet, and who did not use the booklet at all. All interviews were both video and audio taped. Data were analyzed using a thematic analysis approach.

Results The study population included four “users”, eight “readers”, and five “non-users”. Three core themes with barriers and facilitators emerged from the data analysis: 1. The role of health care providers; 2. Patients’ perceptions about OA and its manageability; and 3. Patients’ perceptions about the usefulness of the booklet and information preferences. Regarding theme 1, patient perceived barriers were the lack of information given by health care providers about how to use the booklet, the limited encouragement to use the booklet in the management of OA, and the doubts concerning the health care providers’ endorsement of non-surgical treatment for OA. In contrast, encouragement from health care providers to use and discuss the booklet was also mentioned as being a facilitator. With respect to theme 2 thinking that OA is not treatable or being pro-active during the treatment course is not important were found to be barriers for usage, whereas being convinced about the importance of active participation in the management of OA was identified as a facilitator. Concerning theme 3, not willing to seek information, not wanting to know everything about OA, ignoring OA, or feeling to be already sufficiently informed by health care providers were found to be barriers for usage. On the other hand, the perception of having insufficient knowledge about OA or being interested in having more information served as facilitators to read or use the booklet.

Conclusions Barriers and facilitators for patients with hip or knee OA to use a self-management booklet included the role of health care providers, patients’ perceptions about OA and its manageability and patients’ views on the provision of information. These findings suggest that an active positive attitude of the health care providers towards treatment modalities for OA and the usage of the booklet in the management of OA, with ensuing support in using the booklet tailored to the patients’ perceptions of OA and information provision may increase usage.

References

1. Smink A. et al. (2011). Clin Rheumatol;30:1623-9

Disclosure of Interest None Declared