Patients' Perceptions of Assessment and Treatment of Knee Osteoarthritis in Primary Care

NCT05566925 | Active Not Recruiting

• 1 other identifier: 276518_interview_KOA
• Study Type: observational
• Target: 15
• Locations: 1 country
• Sites: 2

Brief Summary

Background: To diagnose osteoarthritis (OA), Swedish guidelines recommend an overall assessment including patient history, symptoms, and clinical findings. However, diagnostic radiography is not recommended when assessing OA. Assessing and giving core treatments of patients with knee OA (KOA) is included in physiotherapists' area of expertise. Former studies show that there is no statistically significant difference in health-related quality of life for patients with KOA assessed by physiotherapists compared to being assessed by a physician in primary care. There is also research showing that costs can be reduced with a physiotherapist as first assessor. A task-shifting care model with physiotherapists as the primary assessor, can result in a reduced waiting time to recommended treatment for patients with KOA, as well as increase the accessibility to physicians in primary care for patients with more severe health conditions. Previous studies have explored expectations in patients with KOA and how they have experienced the health care when the first assessment and treatment has been performed by a physician. It has been described how referred patients with KOA have experienced physiotherapy treatment, and the physiotherapists' impact on exercise adherence. To the best of our knowledge, there are no studies describing how patients with KOA have experienced health care, when being referred directly to a physiotherapist for assessment and treatment. The main purpose is to explore expectations, perceptions, and experiences among patients with KOA in primary care who have been assessed and treated by a physiotherapist. The second purpose is to explore the possible meaning of the first meeting when it comes to future self-care and experienced health status. Methods: Estimated 12-15 patients with KOA will be recruited from rehabilitation centers in Region Västra Götaland, Sweden, from October 2022 to February 2023. Semi-structured interviews will be conducted and will be analyzed with qualitative content analysis. Expected results: This study is expected to contribute to a deeper understanding of what expectations patients with KOA have before they seek health care, how they experience physiotherapists as primary assessor in KOA and possible influences of the physiotherapy assessment and treatment on patients' perceived health after the rehabilitation period. This knowledge could be valuable when implementing new care models for patients with KOA.

Conditions

Osteoarthritis, Knee

Keywords

Perception; Experience; Physiotherapist; Triage; Direct access

Outcome Measures

Primary Outcomes (3)

• Expectations before meeting with health care

  What expectations did patients with KOA have before meeting with health care? One of the question areas to be answered during a semi-structured interview.

  From 1 to 12 months

• Perceptions when meeting with health care

  What perceptions did patients with KOA have when meeting with the health care? One of the question areas to be answered during a semi-structured interview.

  From 1 to 12 months

• The meaning of the meetings with health care

  What possible influences did meetings with health care have on future self-care and health status? One of the question areas to be answered during a semi-structured interview.

  From 1 to 12 months

Interventions

Direct access to physiotherapist for assessment, diagnosis and treatment. OTHER

Patients with knee osteoarthritis will be interviewed about their experience of being assessed, diagnosed and treated by a physiotherapist first in primary care.

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with knee osteoarthritis in primary care who have been assessed, diagnosed and treated by a physiotherapist first.

You may qualify if:

• Patients with diagnosed knee osteoarthritis, who have been assessed, diagnosed, and treated by a physiotherapist as primary assessor in primary care.
• The patient need to have had at least one month of treatment. The treatment period does not have to be finished.
• Assessed the last year
• Be able to understand and speak the Swedish language

You may not qualify if:

• Pregnancy
• Other severe psychic or somatic disorders or functional impairments that could have affected the treatment of knee osteoarthritis.
• Patient have had the interviewer as assessing and/or treating physiotherapist.

Sponsors & Collaborators

• Vastra Gotaland Region: lead

Study Sites (2)

Närhälsan Lidköping Rehabmottagning

Lidköping, Västra Götaland County, 53151, Sweden

Location

Närhälsan Skara Rehabmottagning

Skara, Västra Götaland County, 53232, Sweden

Location

Related Publications (14)

• Sakellariou G, Conaghan PG, Zhang W, Bijlsma JWJ, Boyesen P, D'Agostino MA, Doherty M, Fodor D, Kloppenburg M, Miese F, Naredo E, Porcheret M, Iagnocco A. EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis. Ann Rheum Dis. 2017 Sep;76(9):1484-1494. doi: 10.1136/annrheumdis-2016-210815. Epub 2017 Apr 7.

  PMID: 28389554 BACKGROUND

• Ho CM, Thorstensson CA, Nordeman L. Physiotherapist as primary assessor for patients with suspected knee osteoarthritis in primary care-a randomised controlled pragmatic study. BMC Musculoskelet Disord. 2019 Jul 13;20(1):329. doi: 10.1186/s12891-019-2690-1.

  PMID: 31301739 BACKGROUND

• Ho-Henriksson CM, Svensson M, Thorstensson CA, Nordeman L. Physiotherapist or physician as primary assessor for patients with suspected knee osteoarthritis in primary care - a cost-effectiveness analysis of a pragmatic trial. BMC Musculoskelet Disord. 2022 Mar 17;23(1):260. doi: 10.1186/s12891-022-05201-3.

  PMID: 35300671 BACKGROUND

• Morris L, Moule P, Pearson J, Foster D, Walsh N. Patient acceptability of the physiotherapy first contact practitioner role in primary care: A realist informed qualitative study. Musculoskeletal Care. 2021 Mar;19(1):38-51. doi: 10.1002/msc.1505. Epub 2020 Sep 28.

  PMID: 32989900 BACKGROUND

• Goodwin R, Moffatt F, Hendrick P, Timmons S, Chadborn N, Logan P. First point of contact physiotherapy; a qualitative study. Physiotherapy. 2020 Sep;108:29-36. doi: 10.1016/j.physio.2020.02.003. Epub 2020 Feb 19.

  PMID: 32693240 BACKGROUND

• Coxon D, Frisher M, Jinks C, Jordan K, Paskins Z, Peat G. The relative importance of perceived doctor's attitude on the decision to consult for symptomatic osteoarthritis: a choice-based conjoint analysis study. BMJ Open. 2015 Oct 26;5(10):e009625. doi: 10.1136/bmjopen-2015-009625.

  PMID: 26503396 BACKGROUND

• Miller KA, Osman F, Baier Manwell L. Patient and physician perceptions of knee and hip osteoarthritis care: A qualitative study. Int J Clin Pract. 2020 Dec;74(12):e13627. doi: 10.1111/ijcp.13627. Epub 2020 Aug 11.

  PMID: 32734667 BACKGROUND

• Alami S, Boutron I, Desjeux D, Hirschhorn M, Meric G, Rannou F, Poiraudeau S. Patients' and practitioners' views of knee osteoarthritis and its management: a qualitative interview study. PLoS One. 2011 May 5;6(5):e19634. doi: 10.1371/journal.pone.0019634.

  PMID: 21573185 BACKGROUND

• Smith TO, Purdy R, Lister S, Salter C, Fleetcroft R, Conaghan PG. Attitudes of people with osteoarthritis towards their conservative management: a systematic review and meta-ethnography. Rheumatol Int. 2014 Mar;34(3):299-313. doi: 10.1007/s00296-013-2905-y. Epub 2013 Dec 5.

  PMID: 24306266 BACKGROUND

• Teo PL, Bennell KL, Lawford B, Egerton T, Dziedzic K, Hinman RS. Patient experiences with physiotherapy for knee osteoarthritis in Australia-a qualitative study. BMJ Open. 2021 Mar 8;11(3):e043689. doi: 10.1136/bmjopen-2020-043689.

  PMID: 34006028 BACKGROUND

• Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 Dec;19(6):349-57. doi: 10.1093/intqhc/mzm042. Epub 2007 Sep 14.

  PMID: 17872937 BACKGROUND

• Graneheim UH, Lindgren BM, Lundman B. Methodological challenges in qualitative content analysis: A discussion paper. Nurse Educ Today. 2017 Sep;56:29-34. doi: 10.1016/j.nedt.2017.06.002. Epub 2017 Jun 17.

  PMID: 28651100 BACKGROUND

• Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004 Feb;24(2):105-12. doi: 10.1016/j.nedt.2003.10.001.

  PMID: 14769454 BACKGROUND

• Ho-Henriksson CM, Thorstensson CA, Nordeman L, Ziden L. "I want to be physically active as long as I live" Expectations and experiences of direct access to physiotherapist in primary healthcare of patients with knee osteoarthritis. Disabil Rehabil. 2025 Jun 17:1-10. doi: 10.1080/09638288.2025.2519494. Online ahead of print.

  PMID: 40524625 DERIVED

Related Links

• Swedish national guidelines for musculoskeletal disorders

MeSH Terms

Conditions

Osteoarthritis, Knee

Interventions

Restraint, Physical; Therapeutics

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Intervention Hierarchy (Ancestors)

Behavior Control; Immobilization; Investigative Techniques

Study Officials

• Chan-Mei Ho-Henriksson, PhD-student

  Närhälsan, Region Västra Götaland

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 27, 2022
• First Posted: October 5, 2022
• Study Start: November 22, 2022
• Primary Completion: June 30, 2025
• Study Completion: June 30, 2025
• Last Updated: December 24, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

SE (2)