OBJECTIVE: To describe the quality of osteoarthritis care in general practice from a patient's perspective and to identify novel associations between process quality indicators and patient-reported outcome and experience measures. METHODS: For this study, 235 persons with knee osteoarthritis completed a survey based on both process and outcome indicators. Process indicators were extracted from international guidelines and included the domains: diagnosis, self-management, treatment and follow-up. The Western Ontario McMaster Universities Osteoarthritis Index and RAND 36-Item Health Survey were used to assess patient-reported outcomes. Patients' reported experience with care was evaluated with the EUROPEP instrument. A series of multilevel regression analyses were then performed to analyze determinants at patient level (i.e. age, gender, BMI and education) and associations between process and outcome indicators. RESULTS: Overall, low adherence to the process indicators was observed (38%), particularly on informing patients on the importance of weight loss (24%, 95%CI: 19-31) or referring them for physical therapy (41%, 95%CI: 33-49). Patients described their quality of life as moderate with an overall score of 63% and 35% on the RAND and WOMAC surveys, respectively. Regarding the determinants, patients with a higher educational level were better informed (OR=3.4, p=0.0003). Associations between process and outcome indicators were scarce, with the exception of patient satisfaction with care and use of NSAIDs (OR=2.9, p=0.0014). CONCLUSION: Patients with knee osteoarthritis receive suboptimal conservative management. They report a moderate quality of life. This study confirms the evidence that NSAIDs are the backbone of osteoarthritis pain management, but now from a patient's perspective. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
OBJECTIVE: To describe the quality of osteoarthritis care in general practice from a patient's perspective and to identify novel associations between process quality indicators and patient-reported outcome and experience measures. METHODS: For this study, 235 persons with knee osteoarthritis completed a survey based on both process and outcome indicators. Process indicators were extracted from international guidelines and included the domains: diagnosis, self-management, treatment and follow-up. The Western Ontario McMaster Universities Osteoarthritis Index and RAND 36-Item Health Survey were used to assess patient-reported outcomes. Patients' reported experience with care was evaluated with the EUROPEP instrument. A series of multilevel regression analyses were then performed to analyze determinants at patient level (i.e. age, gender, BMI and education) and associations between process and outcome indicators. RESULTS: Overall, low adherence to the process indicators was observed (38%), particularly on informing patients on the importance of weight loss (24%, 95%CI: 19-31) or referring them for physical therapy (41%, 95%CI: 33-49). Patients described their quality of life as moderate with an overall score of 63% and 35% on the RAND and WOMAC surveys, respectively. Regarding the determinants, patients with a higher educational level were better informed (OR=3.4, p=0.0003). Associations between process and outcome indicators were scarce, with the exception of patient satisfaction with care and use of NSAIDs (OR=2.9, p=0.0014). CONCLUSION:Patients with knee osteoarthritis receive suboptimal conservative management. They report a moderate quality of life. This study confirms the evidence that NSAIDs are the backbone of osteoarthritis pain management, but now from a patient's perspective. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.