Background Previous research has revealed low adherence with published recommendations for osteoarthritis (OA) care. Little is known about the quality of OA care in Norway and whether OA joint location is of importance for self-reported OA care.
Objectives To investigate patient reported quality indicator (QI) pass rates among members of the Norwegian Rheumatism Association and compare QI pass rates between the different joint locations.
Methods About half of the 2190 members registered with OA as the only rheumatic disease, received a postal questionnaire, while those registered with an email address received a link to an electronic web-survey. The QI pass rates were obtained using the OsteoArthritis Quality Indicator questionnaire1, a 17-item questionnaire that includes QIs related to patient education and information, regular provider assessments, referrals and pharmacological treatment. The total QI pass rate for each person was calculated as the total number of QIs passed, divided by the total number of QIs for which they were eligible. Satisfaction with OA care was reported on a five-point Likert scale (very dissatisfied-very satisfied), and visits to physicians and physiotherapists in the past year were self-reported using six response categorical alternatives (never-more than 12 visits). Mean total QI pass rates were compared across the OA disease locations using Student t-test, and multiple regression analysis was used to assess the association between the total QI pass rate and covariates.
Results The overall response rate was 57% (n=1247). The study sample consisted of 92% females with mean age (sd) 68 (10.3) years, and mean BMI (sd) 27 (4.5). 70% reported OA in their hand, 53% in their hip, and 68% in their knee joints, and 67% reported OA in more than one joint. The mean total QI pass rate was 47%; with 44% vs. 53% for non-pharmacological vs. pharmacological treatments, respectively. The total QI pass rates were similar for those with single site OA vs. multisite OA. Those reporting OA in hand joints only had significantly (p<0.001; t=3.7; 95% CI 3.4, 11.1) lower mean total QI pass rates compared to the rest of the study sample (Figure 1). High total QI pass rates were not associated with gender, but negatively associated with age (B=-0.2, p<0.001; 95% CI -0.3,-0.1) and positively associated with satisfaction with OA care (B=8.0, p<0.001; 95% CI -9.2,-6.6) and with number of visits to physicians (B= 1.8, p<0.01; 95% CI 0.7,3.0) and physiotherapists (B=1.6, p<0.001; 95% CI 1.0,2.1).
Conclusions Persons with only hand OA reported lower quality of OA care compared to persons with lower limb OA, indicating that OA care is dependent on OA joint location. The results show that older persons report lower quality of care compared to younger persons. The low patient self-reported QI pass rates suggest a potential for improvement in OA care, especially for those with hand OA and for non-pharmacological care.
Østerås et al, 2013
Disclosure of Interest None Declared