Table III.
Self-report quality indicators of osteoarthritis care and treatment used within the first 6 months of consultation
| Self-reported OA quality indicators | Intervention | Control | OR (95% CI) | Absolute % differenceΔ (95% CI) | P-value |
|---|---|---|---|---|---|
| Treatment offered | |||||
| ‡Education, advice and access to information | 95.0% | 91.5% | 2.95 (0.68, 12.8) | 5.4% (−3.5%, 7.7%) | 0.148 |
| Support on how to help self with joint problem | 66.9% | 60.1% | 1.91 (0.95, 3.81) | 14.1% (−1.1%, 25.1%) | 0.068 |
| Information/advice about exercises, muscle strengthening or physical activities | 81.5% | 63.3% | 3.01 (1.43, 6.32) | 20.5% (7.9%, 28.3%) | 0.004 |
| Referral to strengthening or physical activities | 54.4% | 46.9% | 1.45 (0.85, 2.55) | 9.2% (−3.9%, 22.3%) | 0.126 |
| #Advice to lose weight | 46.3% | 43.0% | 1.33 (0.79, 2.24) | 7.0% (−5.7%, 19.8%) | 0.288 |
| #Referral to services for losing weight | 16.4% | 12.9% | 2.92 (0.85, 9.98) | 17.3% (−1.7%, 46.7%) | 0.087 |
| Paracetamol recommended for pain | 79.7% | 70.3% | 1.80 (1.03, 4.25) | 10.7% (0.6%, 20.7%) | 0.037 |
| Stronger painkiller | 69.4% | 68.8% | 1.18 (0.71, 1.95) | 3.4% (−7.8%, 12.3%) | 0.529 |
| Information about drugs effect provided | 68.2% | 72.6% | 0.65 (0.39, 1.09) | −9.2% (−21.6%, 1.6%) | 0.101 |
| Corticosteroid joint injection | 35.2% | 35.8% | 1.12 (0.64, 1.84) | 2.6% (−9.6%, 14.8%) | 0.677 |
| Surgery evaluation | 32.3% | 37.0% | 0.82 (0.42, 1.62) | −4.4% (−17.3%, 11.8%) | 0.574 |
| Need for walking aid assessed | 28.9% | 28.9% | 1.05 (0.60, 1.65) | 1.0% (−9.3%, 11.3%) | 0.853 |
| Need for appliances/aids to daily living | 14.4% | 18.2% | 0.91 (0.45, 1.82) | −1.4% (−9.1%, 10.6%) | 0.780 |
| Treatment used | |||||
| ‡Education, advice and access to information | 62.0% | 47.6% | 2.67 (1.62, 4.40) | 23.2% (11.9%, 32.4%) | <0.001 |
| Muscle strengthening exercises | 60.5% | 44.3% | 1.91 (1.20, 3.20) | 16.0% (4.4%, 27.5%) | 0.007 |
| General fitness exercises | 38.0% | 35.4% | 0.80 (0.45, 1.29) | −4.8% (−15.6%, 6.0%) | 0.384 |
| Physiotherapy | 40.1% | 38.6% | 0.65 (0.38, 1.13) | −9.5% (−19.4%, 2.9%) | 0.126 |
| #Dieting to lose weight | 48.4% | 50.9% | 0.87 (0.52, 1.44) | −3.6% (−16.0%, 8.9%) | 0.577 |
| Paracetamol | 86.5% | 84.8% | 1.24 (0.63, 2.44) | 2.6% (−7.0%, 8.4%) | 0.535 |
| Anti-inflammatory creams/gels e.g., topical NSAIDs | 81.6% | 79.8% | 1.21 (0.67, 2.21) | 2.9% (−7.3%, 9.9%) | 0.527 |
| Capsaicin cream | 21.8% | 19.4% | 1.55 (0.87, 2.77) | 7.7% (−2.2%, 20.6%) | 0.141 |
| Anti-inflammatory tablets, e.g., oral NSAIDs | 59.9% | 70.6% | 0.51 (0.31, 0.85) | −15.6% (−28.3%, −3.5%) | 0.010 |
| Stronger painkillers, e.g., Opioids | 62.9% | 62.6% | 1.12 (0.70, 1.80) | 2.7% (−8.6%, 12.5%) | 0.626 |
| Community pharmacy | 25.8% | 16.5% | 1.84 (1.02, 3.34) | 10.2% (0.3%, 23.3%) | 0.043 |
| Walking aids | 41.9% | 50.4% | 0.57 (0.34, 0.94) | −13.9% (−24.6%, −1.6%) | 0.027 |
| Shock-absorbing shoes or insoles | 34.8% | 31.8% | 1.34 (0.81, 2.21) | 6.6% (−4.5%, 18.9%) | 0.259 |
| Appliances and support and braces | 33.0% | 36.9% | 0.78 (0.44, 1.25) | −5.5% (−16.3%, 5.4%) | 0.321 |
| Assistive devices | 25.1% | 25.2% | 1.35 (0.81, 2.07) | 6.1% (−3.7%, 15.9%) | 0.222 |
| Transcutaneous electric nerve stimulation (TENS) | 16.2% | 16.4% | 0.98 (0.52, 1.82) | −0.3% (−7.1%, 9.9%) | 0.944 |
| Warmth, heat or cold application | 61.2% | 58.4% | 1.10 (0.69, 1.75) | 2.3% (−9.1%, 12.7%) | 0.688 |
Results were derived through multiple imputation of missing data using chained equations with mixed models for estimating coefficients (hence, denominator population n = 525; except for # which included 390 participants classified as clinically overweight or obese (classified as having a BMI ≥ 25 kg m−2)).
Δ Absolute percent differences were calculated by applying odds ratios derived by logistic mixed regression adjusted for age, sex and practice size to percent figures for the reference (control group) (clustering by GP practice accounted for in the mixed model). % difference relates to % in intervention group – % in control group.
‡ Comprises written or verbal information about joint problem, information about treatments and advice on self-management of joint problem.