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Understanding the management of osteoarthritis in Australia: a qualitative study of GPs and orthopaedic surgeons in Tasmania, Australia

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Sutton, L, Jose, K ORCID: 0000-0002-9346-6429, Betzold, A, Hansen, E ORCID: 0000-0003-4733-3411, Laslett, L ORCID: 0000-0002-4336-0095, Makin, J ORCID: 0000-0001-7556-196X, Winzenberg, T ORCID: 0000-0002-4112-3491, Balogun, S and Aitken, D ORCID: 0000-0001-5685-7634 2021 , 'Understanding the management of osteoarthritis in Australia: a qualitative study of GPs and orthopaedic surgeons in Tasmania, Australia' , Osteoarthritis and Cartilage Open, vol. 3, no. 4 , pp. 1-6 , doi: 10.1016/j.ocarto.2021.100218.

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Abstract

ObjectiveUsing a qualitative design this study aimed to 1) explore the attitudes towards and understanding of osteoarthritis (OA) held by Tasmanian general practitioners (GPs) and orthopaedic surgeons, 2) gain a deeper understanding of conservative and surgical management and 3) identify key barriers and challenges.DesignPurposive sampling was used to recruit 17 ​GPs and 10 surgeons from Tasmania, Australia. Semi-structured interviews were audio-recorded, transcribed, coded, and thematically analysed to document understanding of OA, management and treatment decision making.ResultsGPs and surgeons had a shared understanding of the cause and management of OA which aligned well with evidence-based best practice. Most GPs acknowledged that severity of disease on an X-Ray does not correlate well with symptoms, although some GPs reported always using imaging to support their diagnosis. Conservative management was highly supported by all interviewees, focussing on exercise and/or physiotherapy. Key treatment barriers included managing poor patient understanding of OA, unrealistic expectations for treatment, lack of patient motivation and scepticism towards exercise, and cost and accessibility of conservative treatment options. Surgery was considered a suitable option when conservative management options had been exhausted.ConclusionThis study uniquely interviewed GPs and surgeons from the same population, capturing two crucial areas of OA management. Some key barriers to treatment were identified and options for improving treatment include creating opportunities for increased patient education about OA, enhanced accessibility to OA conservative management programs along with improved reimbursement models supporting conservative management as first-line OA treatment.

Item Type: Article
Authors/Creators:Sutton, L and Jose, K and Betzold, A and Hansen, E and Laslett, L and Makin, J and Winzenberg, T and Balogun, S and Aitken, D
Keywords: conservative management, general practitioners, surgery, clinical care guidelines, surgeons
Journal or Publication Title: Osteoarthritis and Cartilage Open
Publisher: W B Saunders Co Ltd
ISSN: 2665-9131
DOI / ID Number: 10.1016/j.ocarto.2021.100218
Copyright Information:

© 2021 The Author(s). Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International (OARSI). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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