Table 3.
Statements for inclusion in the model OA consultation
|
Statement1 |
No. (%) GP Group would include (n = 15) |
No. (%) Patient Group would include (n = 14) |
|---|---|---|
| The GP:2 | ||
| Encourages the patient to give a full account of the problem(s), including the reason for coming today |
15 (100) |
11 (79) |
| Finds out how long the patient has had the knee problem for and whether the problem comes and goes |
14 (93) |
12 (86) |
| Asks specific questions about the amount and type of any pain |
14 (100) |
11 (79) |
| Asks about other knee symptoms such as stiffness, locking and giving way |
13 (93) |
12 (86) |
| Asks about problems with mobility, such as walking, going up and down stairs, and getting in and out of a chair |
13 (93) |
9 (64) |
| Asks if, and how, the knee problem affects activities such as work, hobbies, sports and general leisure activities |
14 (100) |
7 (50) |
| Asks about previous problems with the knee, knee operations, knee injections |
13 (93) |
11 (79) |
| Asks about problems with other joints, especially the other knee and the hips |
14 (93) |
8 (62) |
| Asks about the patient’s ideas, concerns, fears and feelings about the problem |
14 (93) |
7 (54) |
|
Asks if the patient has tried anything to help the problem, and if yes, what/how used/how effective |
15 (100) |
12 (92) |
| Checks if there is anything in the patient’s story to suggest a fracture, cancer, inflammatory or septic arthritis |
14 (93) |
7 (54) |
| Examines the knee joint and surrounding tissues |
15 (100) |
11 (85) |
|
Informs the patient that the most likely reason for the problem is osteoarthritis and explains the reason(s) for coming to this diagnosis |
15 (100) |
12 (92) |
|
Gives a brief explanation of osteoarthritis |
14 (93) |
12 (92) |
| Asks if the patient has any unanswered questions |
15 (100) |
8 (57) |
| Hands the guidebook to the patient with the advice to read it |
14 (93) |
8 (62) |
| Encourages the patient to consider the use of “NICE core treatments”, increased physical activity/muscle strengthening exercises/dietary changes to lose weight, if needed |
14 (93) |
10 (77) |
| Emphasises, when relevant, the benefit of losing weight: that if weight is lost then the pain reduces |
14 (93) |
10 (77) |
| Emphasises, when relevant, the benefit of exercise in helping to lose weight in addition to the benefits for osteoarthritis |
14 (93) |
8 (62) |
|
Enquires about the patient’s need for painkillers |
15 (100) |
13 (100) |
|
Recommends the use of paracetamol and/or topical NSAIDs (creams or ointments) before the use of other painkillers |
15 (100) |
13 (100) |
| Summarises the management plan and re-checks that it is acceptable to the patient |
14 (93) |
9 (64) |
|
Advises the patient to make a follow up appointment with the specially trained healthcare professional |
15 (100) |
13 (93) |
| Uses free-text to record the consultation in the paper/electronic records |
14 (93) |
8 (67) |
| In addition to statement above records coded data on the; i) diagnosis and ii) main elements of the consultation, such as the level of pain, the BMI and advice to exercise | 15 (100) | 10 (77) |
1 Statement in bold if 90% or more agreement in BOTH groups.
2 “The GP” is the stem for all the statements.