Practitioner Practice Research Articles

Knowledge, Perception, and Practices on the Labelling of Dispensed Medicine among Community Pharmacists and General Practitioners in the State of Sarawak, Malaysia.

The labelling of dispensed medicines (LDM) ensures that optimum therapeutic treatment levels are achieved, and medication errors are prevented. In Malaysia, LDM is enforced under the Poisons Act 1952. To explore the knowledge, perception, and practices of community pharmacists (CP) and general practitioners (GP) on LDM. A cross-sectional study was conducted from April 2019 until March 2020 among CP and GP practising in Sarawak, Malaysia. Sample sizes were 90 and 150 for CP and GP, respectively. Proportionate stratified random sampling was employed. A self-administered structured questionnaire pre-tested and pilot-tested was used to explore knowledge and perception. Practices were assessed by having participants prepare dispensed medicine labels (DML) using simulated prescriptions. 250 participants; 96 CP and 154 GP participated. While most of them perceived that they knew the requirements of LDM (n = 244; 97.6%), their median knowledge score was poor (57.1%). The mean knowledge score of CP (62.0%) was significantly higher (P = 0.002) than GP (51.0%). The majority of participants perceived that LDM is important (n = 237; 94.8%) and necessary (n = 239; 95.6%) and perceived that poor compliance with the requirements would lead to medication errors (n = 243; 97.2%). Although their knowledge was poor, their median practice score (100.0%) was excellent. There was no correlation between knowledge and perception with the practice of LDM. The majority of CP and GP perceived that LDM is important. Interestingly, although their knowledge of the requirements of LDM was poor, their practices were sound.

Appraisal of National Institute for Health and Care Research activity in primary care in England: cross-sectional study.

The National Institute for Health and Care Research (NIHR) was set up to enhance clinical and health research activity in a variety of National Health Service (NHS) healthcare settings, including primary care. To appraise how overall General Practitioner (GP) practice performance, location, and staffing levels may interact with NIHR Portfolio activity in primary care in England. Cross-sectional summary of GP practice research activity and practice descriptors; complete data from 6,171 GP practices was collated from NIHR (using data for 2013-2023 for Portfolio studies), Public Health England, Care Quality Commission, and NHS Digital sources, respectively. In primary care, 1 million patients have been recruited into NIHR Portfolio studies in the last decade. The top 10% of practices-measured by different studies recruited to-contributed over 50% of that accrual. When the top decile of GP practices is compared to the 20% least active GP practices, research activity is significantly and individually linked with larger GP practices. Furthermore, it is significantly yet modestly associated with GP practice performance (positive patient feedback, Care Quality Commission rating), lower locality deprivation levels, and lower patient to GP ratios. Research activity in GP practices is-as seen previously with hospitals-significantly linked with better GP practice performance and patient feedback. Practice list size and staffing levels in particular interact with the aforementioned. This should be taken into account when determining strategies to increase patient and GP practice participation in NIHR Portfolio research studies.

Use of point-of-care ultrasound in rural British Columbia: Scale, training, and barriers.

To determine the scale and scope of use of point-of-care ultrasound (POCUS) in rural British Columbia (BC). Online survey. Rural BC. Physicians practising in rural BC communities. Practitioner demographic and practice characteristics, locations and frequency of POCUS use, POCUS education and training, and practitioner attitudes about and barriers to POCUS use. Two hundred twenty-seven surveys were completed in fall 2021, corresponding to a response rate of 11.9% of all rural practitioners in BC. A total of 52.1% of respondents worked in communities with less than 10,000 people, while 24.9% had practices with relatively large proportions of Indigenous patients (more than 20% of the practice population). Respondents reported ease of access to local POCUS devices, with use highest in emergency departments (87.2%) followed by ambulatory care clinic (54.7%) and inpatient (50.3%) settings. Use of POCUS influenced clinical decision making in half the occasions in which it was employed, including a range of diagnostic and procedural applications. Barriers to use included lack of training, limited time to perform POCUS scans, and absence of image review or consultative support. Needed support for POCUS identified by respondents included real-time image acquisition advice and funding for both device acquisition and training. Recommendations for including POCUS training in undergraduate and residency education were strongly supported. Use of POCUS in BC is expanding in frequency, scope, and scale in practices serving rural areas and in rural communities with large Indigenous populations, with practitioners reporting important improvements in clinical care as a result. Future research could help improve systemic support for POCUS use, guide needed curriculum changes in medical school and postgraduate training, and be used to inform continuing professional development needs.

State scope of practice restrictions and nurse practitioner practice in nursing homes: 2012-2019.

Increased engagement of nurse practitioners (NPs) has been recommended as a way to address care delivery challenges in settings that struggle to attract physicians, such as primary care and rural areas. Nursing homes also face such physician shortages. We evaluated the role of state scope of practice regulations on NP practice in nursing homes in 2012-2019. Using linear probability models, we estimated the proportion of NP-delivered visits to patients in nursing homes as a function of state scope of practice regulations. Control variables included county demographic, socioeconomic, and health care workforce characteristics; state fixed effects; and year indicators. The proportion of nursing home visits conducted by NPs increased from 24% in 2012 to 42% in 2019. Expanded scope of practice regulation was associated with a greater proportion and total volume of nursing home visits conducted by NPs in counties with at least 1 NP visit. These relationships were concentrated among short-stay patients in urban counties. Removing scope of practice restrictions on NPs may address clinician shortages in nursing homes in urban areas where NPs already practice in nursing homes. However, improving access to advanced clinician care for long-term care residents and for patients in rural locations may require additional interventions and resources.

Challenges and conditions for successfully implementing and adopting the telematics infrastructure in German outpatient healthcare: A qualitative study applying the NASSS framework.

Germany's healthcare system provides high-quality, universal health coverage to almost all residents. However, a major challenge lies in the strong separation of healthcare structures, which hinders efficient interprofessional and intersectoral communication and collaboration. The mandatory nationwide implementation of the telematics infrastructure may offer a solution to enhance healthcare professionals' communication and collaboration. Our study aims to elicit participants' perceptions of and attitudes towards the implementation and usage of the telematics infrastructure in fostering interprofessional communication and collaboration between home-care nursing services and general practitioner practices. We conducted interviews with seven members of general practitioner practices and 10 in home-care nursing services. Using thematic content analysis, we identified five themes, of which four along with 10 subthemes were integrated into Greenhalgh et al.'s 'nonadoption, abandonment, scale-up, spread and sustainability' framework. Participants recognised the potential of digital technology to enhance interprofessional communication and collaboration. However, this potential largely depended on individual healthcare actors' willingness to seek information, invest and adapt. Attitudes towards the telematics infrastructure varied widely from hopeful confidence to outright rejection. Home-care nursing services generally viewed the telematics infrastructure with optimism, while general practitioners expressed reservations, particularly due to technological disruptions, lack of user-friendliness, and organisational structures. Our findings highlight the potential of digital technology to enhance interprofessional communication. Successful implementation of technological innovations, however, goes beyond technological aspects and involves social, political and organisational processes. Future implementation strategies for such innovations in healthcare should involve users early and ensure clear communication.

Cluster randomised controlled trial of specialist-led integrated COPD care (INTEGR COPD)

ObjectiveStudies in hospital settings demonstrate that there is greater guideline adherence when care is delivered by a respiratory specialist, however, this has not been explored in primary care. The aim...

Assessment of the knowledge and practice of Jordanian family medicine practitioners regarding vitamin B12 screening for type 2 diabetes mellitus patients on metformin

Assessment of the knowledge and practice of Jordanian family medicine practitioners regarding vitamin B12 screening for type 2 diabetes mellitus patients on metformin

Practice and attitude of general practitioners towards initiating isotretinoin for acne vulgaris in Fars province, Iran: cross-sectional study

BackgroundSince general practitioners manage acne-related referrals, there needs to be more information in Iran about how drugs such as Isotretinoin are prescribed and the treatment plan. Thus, this study aimed to evaluate general practitioners s’ practices and attitudes in prescribing Isotretinoin for acne vulgaris in primary care.MethodsThis web-based cross-sectional descriptive study was conducted using two questionnaires designed with the target population of GPs working in Fars province in 2021 regarding the prescription of Isotretinoin. Moreover, demographic information, questions about interest in dermatology, and participation in dermatology workshops were gathered.ResultsA total of 308 complete questionnaires were obtained. According to our results, 85 (27.6%) GPs prescribed Isotretinoin in primary care. Based on our results, higher age (OR: 1.042; CI95%: 1.013–1.072; P-value:0.004) and attending dermatological courses (OR: 3.280; CI95%: 1.592–6.755; P-value:0.001) were significantly correlated with more frequent Isotretinoin administration. Among GPs who do not prescribe Isotretinoin, the most common causes are concerns about liver dysfunction (54.7%), teratogenic concerns (37.2%), and lack of familiarity with the drug (31.4%) respectively.ConclusionThe results of this study depicted the reluctance of most physicians to prescribe Isotretinoin and factors such as taking part in supplementary courses under the supervision of dermatologists and following national guidelines that could encourage them to prescribe Isotretinoin.

The association of medical, social, and normative factors with the implementation of end-of-life care practices

BackgroundEnd-of-life (EoL) care practices (EoLCP) are procedures carried out at the EoL and bear directly on this stage in the patient’s life. Public support of these practices in Israel is far from uniform. Previous studies show that while ∼30% of participants support artificial respiration or feeding of terminally ill patients, 66% support analgesic treatment, even at the risk of shortening life. This study aimed to create a typology of six end-of-life care practices in Israel and assess the association of medical, social, and normative factors with the implementation of those practices. These practices included mechanical ventilation, artificial feeding, deep sedation, providing information to the patient and family caregivers, including family caregivers in EoL decision-making, and opting for death at home.MethodsThis cross-sectional study was performed as an online survey of 605 adults aged 50 or more in Israel, of which ~ 50% (n = 297) reported supporting a dying terminally ill relative in the last 3 years. Participants were requested to provide their account of the EoL process of their relative dying from a terminal illness in several aspects, as well as the EoL care practices utilized by them.ResultsThe accounts of the 297 interviewees who supported a dying relative reveal a varied EoL typology. The utilization of end-of-life care practices was associated with the socio-normative beliefs of family caregivers but not with their socioeconomic status. Strong correlations were found between family caregiver support for three key practices (mechanical ventilation, artificial feeding, and family involvement in EoL) and the actual utilization of these practices in the care of dying patients.ConclusionsThe findings portray an important image of equity in the utilization of EoLCP in Israel, as the use of these practices was not associated with socioeconomic status. At the same time, the study found substantial diversity in family caregivers’ preferences regarding EoL care practices use not related to socioeconomic status. We believe that differences in preferences that do not lead to problems with equity or other important societal values should be respected. Accordingly, policymakers and health system leaders should resist calls for legislation that would impose uniform EoL practices for all Israelis. Instead, they should take concrete steps to preserve and enhance the widespread current practice of practitioners to adapt EoL care to the varied needs and preferences of Israeli families and cultural, social, and religious subgroups. These steps should include providing frameworks and tools for family caregivers to support their loved ones close to their deaths, such as educational programs, seminars, supportive care before and during the end of life of their loved ones, etc.

Self-Esteem and Occupational Factors as Predictors of the Incidence of Anxiety and Depression among Healthcare Workers during the COVID-19 Pandemic in Latvia.

The prevalence of depression and anxiety among healthcare workers (HCWs) during the COVID-19 pandemic is high. The aim of the study is to identify the importance of self-esteem and occupational factors in association with the incidence of depression and anxiety among HCWs through a longitudinal cohort study during the COVID-19 pandemic in Latvia. Participants received seven questionnaires during the COVID-19 pandemic on demographic parameters, work-related information, and contact with COVID-19 patients, and three standardized questionnaires that evaluated symptoms of anxiety (GAD-7), depression (PHQ-9), and self-esteem (Rosenberg's self-esteem scale). The Generalized Linear Mixed Model (GLMM) was used to identify factors associated with the incidence of depression and anxiety among HCWs. A total of 322 participants were included in the data analysis for depression and 352 for anxiety. HCWs with low self-esteem were 83% more likely to experience depression and 76% more likely to experience anxiety. Working at a general practitioner practice is associated with twice the risk of developing depression and anxiety. A 31% increase in the odds of depression is observed among HCWs with direct contact with COVID-19 patients. The organizational and government levels must look for opportunities to facilitate the mental health of HCWs to ensure better-quality healthcare.

Prehospital Standards for Point of Care Ultrasound

Point of care ultrasound (POCUS) has become an increasingly recognized tool for the rapid bedside assessment of undifferentiated patients. With the advent of affordable portable devices, this tool has expanded to the prehospital world, offering an opportunity to improve patient care prior to arrival in the emergency department. To assess how this tool has become incorporated into paramedical care in Canada, we conducted a cross-sectional survey of paramedical licensing bodies across Canada investigating POCUS accreditation, licensing, scope of practice, and quality assurance regulation for paramedics. Overall, few provincial paramedical licensing bodies include POCUS in the scope of practice for prehospital practitioners, and those who do are not involved with POCUS training, licensing, or quality assurance. Our findings highlight the need for defined competence standards and quality assurance metrics to ensure safe and effective use of this bedside tool.

Evaluation of the current situation and quality of neonatal hearing screening from hearing screening practitioners’ perspective: a cross-sectional study

Background In recent years, neonatal hearing screening (NHS) has gained rapid traction in both developed and developing nations. However, the efficacy of these efforts depends on comprehensive standardization across all screening facets. This study aimed to assess the status and quality of NHS by investigating the knowledge, attitudes, beliefs, and practices of hearing screening practitioners regarding NHS. Methods A cross-sectional survey was conducted, and an online questionnaire based on the knowledge-attitude/belief (A/B)-practice model was distributed to all NHS practitioners in Luzhou, western China. Valid questionnaires were examined and uniformly graded. Results A total of 63 valid questionnaires were collected. The practitioners were mainly female (96.83%), with nursing backgrounds (63.49%), and undergraduate degrees (66.67%). Most had ≤5 years of experience (74.60%) and had junior/intermediate titles (93.65%). The NHS within the Luzhou area started in 2006 with provincial institutions, expanding to 42 institutions by 2022. Statistically significant correlations were observed between the A/B score and the conducting years of each NHS institution (p < .05) as well as between the Knowledge (K) and Practice (P) scores (p < .01). No significant correlation was found between the K score, P score, A/B score, and working years of practitioners (p > .05), or in the total score of NHS institutions at different levels or in different counties by one-way ANOVA (p > .05). Conclusions It has been 17 years since the first medical institution in Luzhou launched NHS, and the overall performance of practitioners from different institutions has been consistent in terms of their knowledge, attitudes, or level of practice. However, there is room for further improvement in both the professional development of individuals and aspects related to work, such as health education and long-term follow-up.

How coaches design small-sided games in rugby union: a practice-based review

Background: Game-based training (GBT) is a holistic method for improving performance in team sports. Task constraints and design parameters can affect training effectiveness. The evidence on how small-sided game (SSG) design in rugby union (RU) influences outcome variables is lagging. No study has investigated the contemporary SSG practices of RU practitioners in different performance contexts. Methods An anonymous online survey with twenty-four questions was distributed to RU training staff six times worldwide in one year through multiple e-platforms. A frequency analysis was used to assess responses and contrast it with the literature. Results: 115 surveys were recorded. The dominant characteristics were &gt;5 y experience (66% of respondents), head coach position (53%), New Zealand-based (77%), coaching male players (69%) on the local/school level (68%). Higher-level practitioners applied larger SSG formats with shorter duration, using more extreme pitch sizes and less tackling, for conditioning purposes primarily. Lower-level practitioners targeted fun and technique. Smaller game formats and tackling were used more in male and youth players, and on the lower levels. Further observed differences relate to practitioner role, experience, and geographical location. Conclusion: Practitioners design SSG differently depending on their coaching background, target population, competition level, and geographical location. Practitioner education on GBT would optimise RU training practice. This study provides performance-contextual insights.

Knowledge, Attitude and Practice Among Private Dental Practitioners Towards Preventive Dental Measures of Pediatric Patients in Namakkal District: A Questionnaire Based Study

Aim: To assess the knowledge, attitudes, and practices of private dental practitioners in Namakkal District, Tamil Nadu, regarding preventive dental practice. Material and Methods: We conducted a descriptive cross-sectional survey using a 20-item closed-end questionnaire. We analyzed the data using Microsoft Excel and IBM SPSS Statistics version 25.0, employing statistical tests such as the frequency test, Mann-Whitney U test, and Spearman's rho correlation test. Results: A total of 200 dental professionals participated in the study, with 47.5% being male and 52.5% female. Of the participants, 68% were under the age of 35, while 32% were 35 years or older. Qualification distribution showed that 47.5% were dental graduates and 52.5% were dental specialists. We observed a highly significant difference in knowledge compared to attitude and practice. The mean±SD scores were 7.84±2.139 for knowledge, 3.11±0.955 for attitude, and 3.51±1.143 for practice. Statistically significant correlations were found between attitude and practice (0.246, p&lt;0.0001). Conclusion: Dental practitioners in Namakkal District, Tamil Nadu, demonstrated substantial knowledge and a positive attitude toward preventive dentistry, and they generally adopted preventive measures in their practice.

Attitudes of general dental practitioners toward preventive approach in pediatric patients: A cross-sectional survey

Abstract Objective: This cross-sectional survey aimed to assess the attitudes and practices of general dental practitioners regarding a preventive approach in pediatric patients. Methods: This cross-sectional survey involved 279 general dental practitioners and employed a structured questionnaire comprising multiple items to assess their attitudes and practices related to a preventive approach in pediatric patients and data were analyzed using the descriptive statistics and Chi-square tests. Results: The survey revealed that 60.1% of pediatric patients visited the clinic frequently and 71.0% were treated directly by the dentists. A preventive approach was common (69.2%) among practitioners. Prescription practices showed that 57.1% of dentists prescribed a specified amount of fluoridated toothpaste and 62.5% preferred fluoride gel over varnish. Nonfluoride remineralizing agents were preferred by 60.0% of dentists. Glass ionomer cement (66.7%) was preferred for pit fissure sealant applications. Conclusion: The survey indicates that general dental practitioners have a positive attitude toward preventive care in pediatric patients. However, further education and knowledge dissemination are needed to enhance their understanding and confidence.

Indian Society of Periodontology Good Clinical Practice Recommendations for Peri-implant Care.

Current implant therapy is a frequently employed treatment for individuals who have lost teeth, as it offers functional and biological advantages over old prostheses. Concurrently, active exploration of intervention strategies aims to prevent the progression of peri-implant diseases and manage the existing peri-implant tissue damage. Indian Society of Periodontology has recognized the need for systematic documents to update the everyday clinical practice of general dental practitioners and has provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral health-care delivery across the country. The current clinical practice recommendations focused on peri-implant care to bridge the gap between academic theory and clinical practice by compiling evidence-based suggestions for preventing and treating peri-implant diseases. Twenty-eight subject experts across the country prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three sections covering peri-implant health and maintenance, peri-implant mucositis, and peri-implantitis. It will be a quick and concise reference for oral implant practitioners in patient management. The guidelines provide distinct definitions, signs, and symptoms, treatment required; recall visit specifications for plausible clinical case situations, and home-care recommendations regarding maintaining peri-implant health. The document advocates combined efforts of oral implant practitioners and the population at large with evidence-based, integrated, and comprehensive peri-implant care. By providing accessible, applicable guidance, these guidelines would empower dental professionals to uphold the well-being of implant patients and ensure the long-term success of implant therapy.

Attitude and Practice of Dental Practitioners Towards the Oral Biopsy Procedure: A Questionnaire-based Cross-sectional Study

Introduction: Dentists, the first medical professionals to be consulted for conditions involving the oral cavity, have the distinct advantage of being in a position to screen patients for oral cancer. To effectively manage patients, dentists must be familiar not only with where, when, how and why to perform biopsies, but also with when to refer them to specialised institutions. Aim: To assess the attitude and practice of dental practitioners towards the oral biopsy procedure. Materials and Methods: The present questionnaire-based cross-sectional study was conducted in the city of Jamnagar, Gujarat, India, from July 2023 to August 2023. Fifty dental practitioners with a minimum academic qualification of Bachelor of Dental Surgery (BDS) participated in the study, which was designed to collect information regarding the importance of oral biopsy, methods used to obtain biopsies, tissue preservation, diagnosis, referral to higher centers and the attitudes and practices of dental practitioners in examining oral mucosal lesions. The questionnaire was prepared using the Google Forms app. The received responses were compiled and statistical data (percentage) was calculated using Microsoft Excel 2020. Results: Out of total, 42 (84%) dentists encounter up to 10 oral mucosal lesions, such as potentially malignant disorders, in a month. Despite this, only 22% (n=11) of them performed biopsies themselves. Furthermore, 6 (12%) dentists did not know the proper medium for preserving biopsies. Of all, 24 (48%) dentists felt the need for proper training in biopsy techniques to be included in the undergraduate curriculum. Conclusion: Despite being aware of the importance of biopsy as a crucial diagnostic procedure, not many dentists perform it routinely due to reasons such as lack of training, patient non compliance and medicolegal implications. Hence, dentists should be educated in performing the oral biopsy procedure, including handling of specimens and referral to specialists.

Enhancing Psychological Wellbeing Practitioner (PWP) practice for depression and anxiety in the context of personality difficulties: a pilot audit of CPD workshop feedback

Abstract Psychological Wellbeing Practitioners (PWPs) are central to NHS Talking Therapies services for depression and anxiety (TTad; formerly ‘IAPT’). This workforce has been trained to deliver low-intensity treatments for mild to moderate depression and anxiety. In practice, PWPs routinely work with more complex clients, likely due to a combination of reasons. Over half of referrals experience concurrent personality difficulties, which are linked to poorer treatment outcomes, and PWPs describe feeling unskilled to work with these clients. This study aimed to develop and pilot a Continuing Professional Development workshop for PWPs about enhancing practice in the context of concurrent personality difficulties; and evaluate acceptability, feasibility and potential impacts on clinical skills and attitudes. This is an audit of routine feedback from a pilot of the workshop offered in a single TTad PWP workforce (n=139). The workshop was successfully developed and a series of five workshops were delivered to 74% of the PWP workforce. Feedback was overwhelmingly positive, and a majority of PWPs reported improved confidence in key skills covered during the workshop, and a positive attitude towards working with clients with personality difficulties after the workshop. PWPs described enhanced capability, opportunity and motivation to undertake work with this client group following the workshop. The workshop showed potential to improve PWP confidence and skill to support TTad clients in the context of personality difficulties, although it is not yet known if this translates to better treatment outcomes for clients. Implications for practice and future research are discussed. Key learning aims (1) Understand the feasibility of gathering feedback and outcome data of a Continuing Professional Development (CPD) workshop delivered in routine practice for PWPs. (2) Understand PWP perspectives on attending a CPD workshop to support tailoring PWP treatments for depression and anxiety in the context of personality difficulties. (3) Reflect on potential opportunity to enhance PWP treatments in the context of personality difficulties via brief training workshops. (4) Consider how COM-B can be used to explore barriers and enablers to PWPs implementing new learning to their practice.

MISSION ABC: transforming respiratory care through one-stop multidisciplinary clinics – an observational study

ObjectivesThe Modern Innovative Solutions to Improve Outcomes in Asthma, Breathlessness and Chronic Obstructive Pulmonary Disease (COPD) (MABC) service aimed to enhance disease management for chronic respiratory conditions through specialist multidisciplinary...

Association between quadriceps tendon elasticity and neuromuscular control in individuals with knee osteoarthritis

BackgroundKnee osteoarthritis is a complex condition with established risk factors such as female sex, increasing age and body mass index, reduced quadriceps muscle strength and knee injury. Despite known associated risks, the role and behaviour of knee tendons in knee osteoarthritis remains unclear. This study explores the association between quadriceps tendon elasticity, muscle strength, neuromuscular control, proprioception and patient reported outcome measures in individuals with knee osteoarthritis. MethodsAdults with doctor-diagnosed knee osteoarthritis were recruited from rheumatology clinics and general practitioner practices. Quadriceps tendon elasticity was estimated using sonoelastography. Neuromuscular control data including electromyography, electromechanical delay and proprioception measures were included. Participants completed the Knee Injury and Osteoarthritis Outcome Score. Associations between elasticity values, physical and neuromuscular data and patient reported outcomes scores were evaluated using Spearman's correlations. FindingsThirty-nine adults with knee osteoarthritis were eligible for inclusion. Increased tendon stiffness was negatively associated with rate of force development, time to half peak force and passive positioning sense in individuals with knee osteoarthritis. Similarly, patient reported symptoms were found to be associated with sonoelastography findings with moderate-strong associations observed between activities of daily living sport and recreation, pain and symptoms and between neuromuscular control measures and muscle strength. InterpretationStiffer tendon identified within the knee osteoarthritis group was associated with reduced neuromuscular control and knee joint proprioception. Stiffer quadriceps tendon may contribute to the poorer reported symptoms by knee osteoarthritis individuals. These findings may impact disease symptoms and progression which could lead to further joint impairment.