Background/Purpose:   Osteoarthritis (OA) is a common cause of pain and disability. The patients’ perception of health care influences their involvement in management, affecting health outcomes and health system utilisation. Thus it is important to understand the consumer’s perceived health service needs in OA. The aim of this systematic review is to identify evidence regarding the consumers’ perceived health service needs regarding OA.

Methods:   A systematic literature review of the MEDLINE, PsychINFO, EMBASE and CINAHL databases was performed to capture information regarding consumer perceived health service needs related to OA (1990 to May 2015). Themes were identified to provide a systematic review of the existing literature.

Results:   1053 manuscripts were identified by the search strategy, of which 18 articles were relevant. Of these, 7 studies used quantitative methods, 10 used qualitative and 1 used mixed methods. These themes emerged (> 2 papers): 1) Patients’ valued being in an individualised relationship with their practitioner. Insufficient practitioner knowledge, an emphasis on analgesic therapies, rejection of alternative medicine options, and poor practitioner communication skills resulted in consumer dissatisfaction. 2) Complementary and alternative medicine use was prevalent amongst OA patients, primarily driven by desire for analgesic relief. The accessibility, empathy, interpersonal skills and holistic patient approach to care contributed to patient satisfaction with complementary and alternative medicine. 3) Attitudes towards medication use was variable. Fear of side effects was the biggest concern. Baseline pain levels and financial constrains impacted the choice of medication used. 4) Patients perceive a need for physiotherapy and exercises for OA, however accessibility was the main barrier to this. This review generated limited studies on geriatric populations and patients from developing countries or non-English speaking backgrounds. There was a paucity of data relating to patient waiting times for specialist review, specialist fees and medication costs and the ease of medication administration.

Conclusion:   Health service delivery in OA is largely driven by patient perceived needs. Aligning perceived needs with health care requirements is important in order to obtain better outcomes in OA. This review revealed that many patient perceived health service needs are aligned with current OA management guidelines. It also identified the barriers to health service implementation. This review also highlights significant gaps in the literature relating to a number of consumers’ perceived needs. A better understanding of these needs may guide the provision of relevant services for those with OA, with the view to optimize patient outcomes and healthcare system utilisation and efficiency.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-systematic-review-of-consumer-perceived-health-service-needs-related-to-osteoarthritis/