Session Information
Date: Tuesday, November 10, 2015
Title: Osteoarthritis - Clinical Aspects Poster II: Biomarkers, Biomechanics and Health Services Research
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: The burden of osteoarthritis (OA) is substantial and expected to increase because people are getting older and heavier. Health care providers need to monitor and improve the quality of health services for people with OA. The purpose of this study was to evaluate the state of quality of care for OA by summarizing studies that have assessed the care provided to patients.
Methods: A systematic review of community-based observational studies that assessed the quality of care for patients living in the community with OA, by comparing actual clinical practice to a quality indicator (QI) was performed. Four databases were searched from January 2000 to November 2014. Two reviewers independently determined study eligibility, assessed risk of bias and extracted study data. The outcome was adherence to the QIs (pass rate), calculated as all instances in which recommended care was received or delivered divided by the number of times participants were eligible. No pooling of overall pass rates was performed, but when at least 50% of the studies had comparable individual QIs, the data were pooled with proportion meta-analyses.
Results: Nine studies from North America and Western Europe comprising 4037 patients were included. The Assessing Care Of Vulnerable Elders (ACOVE) indicators and RAND’s Quality Assessment Tools system and were the most commonly used QI sets. The number of individual indicators in the sets used varied from 3 to 17, and data were collected from medical records in five studies, and by patient reports in four studies. The median overall pass rate across studies was 38% (ranging from 22% to 65%). Six individual indicators were similar across at least five studies, and were consequently pooled (table).
| Quality Indicator |
Pooled Passrate (95% CI) |
| Referral to orthopedic surgeon if no response to other therapy | 73.5 (52.4-87.5) |
| Paracetamol or acetaminophen first drug used | 45.9 (39.6-52.4) |
| Assessed for pain and/or function | 45.8 (30.0-62.5) |
| Offered education and/or self-management | 32.3 (17.8-51.3) |
| Referral or recommendation to exercise | 30.4 (23.4-38.5) |
| Informed about potential risks if NSAIDs prescribed | 21.4 (10.6-38.5) |
Conclusion: On average, one-third of OA patients received first line non-pharmacological approaches, which was significantly lower than the nearly three-quarters referred to orthopedic surgery. This pattern seems to be consistent across North America and Western Europe, and indicates a substantial need for improvement in community-based OA care.
To cite this abstract in AMA style:
Hagen KB, Smedslund G, Østerås N, Jamtvedt G. The Quality of Community-Based Osteoarthritis Care Can be Improved. Results from a Systematic Review and Meta-Analysis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-quality-of-community-based-osteoarthritis-care-can-be-improved-results-from-a-systematic-review-and-meta-analysis/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-quality-of-community-based-osteoarthritis-care-can-be-improved-results-from-a-systematic-review-and-meta-analysis/