Scientific article
OA Policy
English

Patterns of routine primary care for osteoarthritis in the UK : a cross-sectional electronic health records study

Published inBMJ open, vol. 7, no. 12, e019694
Publication date2017-12-29
First online date2017-12-29
Abstract

Objective: To determine common patterns of recorded primary care for osteoarthritis (OA), and patient and provider characteristics associated with the quality of recorded care.

Design: An observational study nested within a cluster-randomised controlled trial.

Setting: Eight UK general practices who were part of the Management of Osteoarthritis in Consultations study.

Participants: Patients recorded as consulting within the eight general practices for clinical OA.

Primary outcomes: Achievement of seven quality indicators of care (pain/function assessment, information provision, exercise/weight advice, analgesics, physiotherapy), recorded through an electronic template or routinely recorded in the electronic healthcare records, was identified for patients aged ≥45 years consulting over a 6-month period with clinical OA. Latent class analysis was used to cluster patients based on care received. Clusters were compared on patient and clinician-level characteristics.

Results: 1724 patients (median by practice 183) consulted with clinical OA. Common patterns of recorded quality care were: cluster 1 (38%, High ) received most quality indicators of care; cluster 2 (11%, Moderate ) had pain and function assessment, and received or were considered for other indicators; cluster 3 (17%, Low ) had pain and function assessment, and received or were considered for paracetamol or topical non-steroidal anti-inflammatory drugs; cluster 4 (35%, None ) had no recorded quality indicators. Patients with higher levels of recorded care consulted a clinician who saw more patients with OA, consulted multiple times and had less morbidity. Those in the High cluster were more likely to have recorded diagnosed OA and have knee/hip OA.

Conclusions: Patterns of recorded care for OA fell into four natural clusters. Appropriate delivery of core interventions and relatively safe pharmacological options for OA are still not consistently recorded as provided in primary care. Further research to understand clinical recording behaviours and determine potential barriers to quality care alongside effective training for clinicians is needed.

Trial registration number: ISRCTN06984617; Results.

Keywords
  • Latent class analysis
  • Osteoarthritis
  • Primary care
  • Quality in health care
  • Aged
  • Aged, 80 and over
  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Cluster Analysis
  • Cross-Sectional Studies
  • Delivery of Health Care / standards
  • Electronic Health Records
  • Female
  • General Practice
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis / therapy
  • Osteoarthritis, Hip / therapy
  • Osteoarthritis, Knee / therapy
  • Pain Measurement
  • Physical Therapy Modalities
  • Primary Health Care
  • Quality Indicators, Health Care
  • Quality of Health Care
  • United Kingdom
Affiliation entities Not a UNIGE publication
Funding
  • Department of Health [IAT/I-PF/010/009]
  • Arthritis Research UK [18139]
  • Department of Health [RP-PG-0407-10386]
  • Department of Health [KMRF-2014-03-002]
  • Department of Health [CAT CDRF 10-018]
  • National Institute for Health Research (NIHR) [CL-2015-10-002]
  • Research Trainees Coordinating Centre
  • Programme Grants for Applied Research
  • Versus Arthritis
Citation (ISO format)
JACKSON, Holly et al. Patterns of routine primary care for osteoarthritis in the UK : a cross-sectional electronic health records study. In: BMJ open, 2017, vol. 7, n° 12, p. e019694. doi: 10.1136/bmjopen-2017-019694
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Additional URL for this publicationhttps://bmjopen.bmj.com/content/7/12/e019694.long
Journal ISSN2044-6055
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Creation05/02/2025 07:21:11
First validation05/03/2025 13:38:47
Update05/03/2025 13:38:47
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