Osteoarthritis of the hip and/or knee in Dutch general practice and physiotherapy practice

Abstract

Purpose: To describe demographic characteristics and the treatment process of patients with hip osteoarthritis (OA) or knee OA treated in Dutch general practice (GP) and/or physiotherapy practice. Additionally, to investigate whether there are differences in characteristics between referred and non-referred patients with hip or knee OA in GP and physiotherapy practice. Methods: Data from two, separate national registration networks were used. Patients who visited their general practitioner and/or physiotherapist between 2006 and 2009 on account of hip or knee OA were included. Demographic data concerned prevalence and incidence rates, gender and age. In GP, prescriptions and referrals were analyzed. In physiotherapy practice, the health problem, the number of treatment sessions, the duration of a treatment episode, the applied interventions and the treatment results were investigated. In case of continue data, two sample t-tests were used to compare between patients with hip OA and patients with knee OA, respectively between referred patients and non-referred patients in GP and in physiotherapy practice. Chi square tests were used to compare categorical variables. Results: In total, 7477 patients were included. Prevalence rates for hip/knee OA comprised 10.4 / 1000 patients in GP and 18.4 / 1000 patients in physiotherapy practice. Both in GP and physiotherapy practice, the OA population included more females than males and more patients with knee OA than hip OA. Forty-five percent of the patients in GP received a medicine, mostly a NSAID. Prescriptions were significantly more common in patients with knee OA than in patients with hip OA. About 5% of the hip/knee population was referred to a physiotherapist. Referred patients were more often treated pharmacologically than non-referred patients. In physiotherapy practice, patients with hip OA were faced significantly longer with complaints than patients with knee OA. There were no significant differences in treatment characteristics between referred patients (68%) and patients who seek help from a physiotherapist on their own initiative (32%). Patients with hip or knee OA in GP who are referred to a physiotherapist were significantly older and more often females in comparison to patients with hip or knee OA in physiotherapy practice who are referred by their GP. Conclusion: In GP, patients with knee OA are more often treated pharmacologically than patients with hip OA. The same applies to patients who are referred for physiotherapy compared to non-referred patients. General practitioners should reconsider the frequent use of NSAID's, because guidelines recommend the use of analgesics as first medicine of choice. In physiotherapy practice, the duration of complaints differs between patients with hip OA and patients with knee OA. There are no differences referred and non-referred patients. At this moment, patient- and treatment characteristics of patients with hip or knee OA are extracted from two separate registration networks. Patient characteristics differed significantly between referred patients in GP and referred patients in physiotherapy practice. Therefore, to enable longitudinal observation of care in patients with hip or knee OA, it is desirable to create a multidisciplinary registration network in which patient oriented data from different care providers is clustered. (aut. ref.)