Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study.

Abstract

ObjectiveTo measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care.MethodsStudy design is a multinational (Australia, New Zealand, Canada) cross‐sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final‐year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high‐ and low‐value care (customized items), attitudes toward exercise/physical activity (free‐text responses).ResultsA total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist‐nurse analyses were 9.3 [7.7‐10.9] for knowledge [scale: 11‐55] and 14.6 [12.3‐17.0] for skills [scale: 16‐80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3‐8.4]; scale 10‐60) and in medical students compared with physiotherapy students (2.0 [1.3‐2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%‐19% and 19%‐22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%‐36% and 35%‐44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%‐61% and 21%‐52%). Most agreed (90%‐98% and 92%‐97%) that exercise is indicated and strongly supported by qualitative data.ConclusionWorkforce capacity building that de‐emphasizes biomedical management and promotes high‐value first‐line care options is needed. Knowledge and skills among physiotherapists support leadership roles in OA care for this discipline.