Abstract
Osteoarthritis is a leading cause of chronic pain and disability and one of the most common conditions diagnosed and managed in primary care. Despite the evidence that patients would value discussions about the course of osteoarthritis to help them make informed treatment decisions and plan for the future, little is known of GPs’ practice of, or views regarding, discussing prognosis with these patients. A cross-sectional postal survey asked 2500 randomly selected UK GPs their views on discussing prognosis with patients with osteoarthritis and potential barriers or facilitators to such discussions. They were also asked if prognostic discussions were part of their current practice and what indicators they considered important in assessing the prognosis associated with osteoarthritis. Of 768 respondents (response rate 30.7 %), the majority felt it necessary to discuss prognosis with osteoarthritis patients (n = 738, 96.1 %), but only two thirds reported that it was part of their routine practice (n = 498, 64.8 %). Most respondents found predicting the course of osteoarthritis (n = 703, 91.8 %) and determining the prognosis of patients difficult (n = 589, 76.7 %). Obesity, level of physical disability and pain severity were considered the most important prognostic indicators in osteoarthritis. Although GPs consider prognostic discussions necessary for patients with osteoarthritis, few prioritise these discussions. Lack of time and perceived difficulties in predicting the disease course and determining prognosis for patients with osteoarthritis may be barriers to engaging in prognostic discussions. Further research is required to identify ways to assist GPs making prognostic predictions for patients with osteoarthritis and facilitate engagement in these discussions.
Highlights
Osteoarthritis (OA) is the most common form of arthritis worldwide, with an estimated prevalence of 20–30 % [1]
Whilst symptom relief is important, it is not the only component of chronic disease management that is important to patients; 80 % of older people presenting to their GP with musculoskeletal pain reported discussion of the likely course and outcome of their condition was important to them, in order to help them make decisions and plan for the future [3]
Essential Often Sometimes Not necessary. These findings suggest that GPs consider prognostic discussions necessary in patients with OA, favour frequent discussion of prognosis and feel that it is the responsibility of both GPs and patients to initiate such discussions
Summary
Osteoarthritis (OA) is the most common form of arthritis worldwide, with an estimated prevalence of 20–30 % [1]. The Global Burden of Health Survey (2010) reported OA to be responsible for 17.1 million years lived with disability worldwide and to be the fastest growing chronic disease [2]. OA is one of the most common diagnoses made in general practice, the setting where the majority of patients are managed. Whilst symptom relief is important, it is not the only component of chronic disease management that is important to patients; 80 % of older people presenting to their GP with musculoskeletal pain reported discussion of the likely course and outcome (prognosis) of their condition was important to them, in order to help them make decisions and plan for the future [3]
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