Article Text

AB1087-HPR Non-Pharmacological, Non-Surgical Care in Hip and Knee Osteoarthritis: The View of Healthcare Providers
  1. E.M. Selten1,
  2. J.E. Vriezekolk1,
  3. W.H. van der Laan2,
  4. R.G. van der Meulen-Dilling3,
  5. M.W. Nijhof4,
  6. H.J. Schers5,
  7. R. Geenen6,
  8. C.H. van den Ende1
  1. 1Department of Rheumatology, Sint Maartenskliniek, Nijmegen
  2. 2Department of Rheumatology, Sint Maartenskliniek, Woerden
  3. 3Physical Therapy and Manual Therapy Velperweg Partnership, Arnhem
  4. 4Department of Orthopedics, Sint Maartenskliniek
  5. 5Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen
  6. 6Department of Psychology, Utrecht University, Utrecht, Netherlands


Background Non-pharmacological, non-surgical treatment modalities are underused in the management of knee and hip osteoarthritis (OA)1. One possible explanation of this suboptimal use could be health care providers' lack of knowledge about non-pharmacological, non-surgical treatment modalities which might act as a barrier for referring patients to these treatment modalities2.

Objectives The objective of this qualitative study was to identify healthcare providers' view on non-pharmacological, non-surgical care of knee and hip OA.

Methods Semi-structured in-depth interviews with 24 healthcare providers working in the field of OA were held (rheumatologists, orthopaedic surgeons, physiotherapists and GPs). Interviews were transcribed verbatim and analysed using a three-step thematic approach consisting of open, axial and selective coding. Two independent researchers continuously reflected upon, compared, discussed and adjusted the coding.

Results Eight themes were identified: 1) patients' difficulties with weight reduction; 2) dieticians' capabilities in weight reduction management; 3) healthcare providers' responsibilities in weight reduction; 4) the importance of lifestyle advices; 5) (mis)trust in physiotherapy modalities; 6) the endorsement of non-pharmacological, non-surgical treatment to delay surgery; 7) dialogue between disciplines; 8) perceptions of healthcare providers' roles.

Conclusions This study identified multiple factors affecting the suboptimal use of non-pharmacological, non-surgical treatment modalities in knee and hip OA from the perspective of the healthcare provider. The results of this study may be used to improve healthcare providers' knowledge and communication skills regarding weight reduction strategies. To enhance the cooperation between health care providers, opportunities should be created for easy referral to effective weight reduction programmes and to evidence-based physiotherapeutic interventions.

  1. McHugh, GA, Luker, KA, Campbell, M, Kay, PR & Silman (2007). A longitudinal study exploring pain control, treatment and service provision for individuals with end-stage lower limb osteoarthritis. Rheumatology 46(4), 631–637.

  2. Hofstede, SN, Vliet Vlieland, TPM, Van den Ende, CHM, Marang - van de Mheen, PJ, Nelissen, RGHH, Van Bodegom - Vos, L. (2014). Designing a strategy to implement optimal conservative treatments in patients with knee or hip osteoarthritis in orthopedic practice: a study protocol of the BART-OP study. Implementation Science 9:22.

Disclosure of Interest None declared

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