Quality indicators (QIs) are evidence-based tools that define the minimum standard of care patients should receive for a health condition. The objective of this presentation is to discuss the use of QIs to assess the quality of non-pharmacological care received by people with knee/hip osteoarthritis (OA) in the community.
We conducted a postal survey to evaluate four Arthritis Foundation quality indicators for knee/hip OA: 1) advice to exercise, 2) advice to lose weight, 3) assessment for ambulatory function, and 4) assessment for non-ambulatory function. Eligible participants were identified from the administrative database of British Columbia, Canada between 1992 and 2006. 1,349 participants reported knee and/or hip OA [knee (51.9%); hip (19.3%); knee and hip=388 (28.8%)]. The overall pass rate of the four quality indicators was 22.4% (95% CI=20.5, 24.3). The pass rate for the individual quality indicator ranged from 6.9% for assessment of non-ambulatory function to 29.2% for receiving assessment of ambulatory function. Receiving exercise advice was associated with having a university degree (versus high school diploma; OR=3.10, 95% CI=2.00, 4.80). Receiving weight-loss advice was associated with being female (OR=2.64, 95% CI=1.71, 4.08), being aged 55–64 years (compared to being aged 75 and over; OR=1.96, 95% CI=1.02, 3.76), and having higher WOMAC scores (for every 10-point increment; OR=1.14, 95% CI=1.02, 1.26). On the other hand, having less than high school education reduced the odds of weight-loss advice (OR=0.52, 95% CI=0.30, 0.88). We concluded that the quality of non-pharmacological care for people with knee/hip OA in the community was suboptimal. In particular, advice on exercise and weight management might not be provided equally across sex, age, disability and formal education levels.
The presentation will conclude by introducing a new initiative led by Dr. Marie Westby to develop QIs on total hip/knee arthroplasty rehabilitation for monitoring quality of care and guiding clinical practice in Canada.
Disclosure of Interest None declared