Cross-perspectives on care pathways for painful osteoarthritis: A qualitative analysis in patients and healthcare professionals.

Abstract

To analyse and compare patients' and healthcare professionals' (HPs) perspectives concerning patient care pathways for painful osteoarthritis (OA). We performed a qualitative study of two focus groups corresponding to eight patients with painful OA and eight HPs involved in OA management. Six key themes emerged from the interviews: (1) representations of OA, (2) OA pain, (3) quality of life, (4) care pathways, (5) actors involved in the care pathway, and (6) treatments. Both groups considered general practitioners, pharmacists and physiotherapists to be first-line HPs, and no well-defined OA specialist was identified. Patients and HPs reported similar difficulties concerning the adaptation of management to individual cases, late diagnosis and treatment, whereas only patients mentioned financial issues. Communication difficulties were identified as a major problem both between patients and HPs, and between HPs. Patients reported a lack of knowledge concerning pain and OA. The coordination between the various HPs is required, with education on both pain and OA. Several possible solutions were put forward by both patients and HPs. The care pathways of patients with painful OA are complex, with an unclear definition of the roles of the various HPs and suboptimal coordination. The role of HPs should be defined and collaboration between HPs developed.