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• W1554031310 abstract "Background: Osteoarthritis (OA) is highly prevalent and has a substantial impact on the quality of life as well as on healthcare costs. The general practitioner (GP) is often the first care provider for patients with this chronic disease. The aim of this study was to identify health care needs of patients with OA and to reveal possible obstacles for improvements in primary care management of OA patients. Methods: We performed semi-structured interviews with a stratified sample of 20 patients, 20 GPs and 20 practice nurses. Results: Diagnosing OA posed no major problem, but during the course of OA, GPs found it difficult to distinguish between complaints resulting from the affection of the joints and complaints related to a concomitant depression. Patients felt to be well informed about the degenerative nature of the disease and possible side effects of medications, but they lacked information on individual consequences of the disease. Therefore, the most important concerns of many patients were pain and fear of disability which they felt were only marginally addressed by GPs. Regarding pain treatment, physicians and patients had an ambivalent attitude towards NSAIDs and opiates. Therefore, pain treatment was not performed according to prevailing guidelines. GPs felt frustrated about the impact of counselling regarding lifestyle changes but on the other hand admitted to have no systematic approach to it. Patients stated to be aware of the impact of lifestyle on OA but lacked detailed information, e.g., on how to exercise. Several suggestions were made concerning improvement. Conclusion: GPs should focus more on disability and pain and on giving information about treatment since these topics are inadequately addressed. Advanced approaches are needed to increase GPs impact on patients' lifestyle. Being aware of the problem of labelling patients as chronically ill a more proactive, patient-centred care is needed. 8 Problems and needs of osteoarthritis patients 17 Background About 10% of men and 18% of women aged 60 years and over suffer from symptomatic osteoarthritis (OA). Due to increasing life-expectancy as well as constant increase in the average body mass index, which constitutes a principal risk factor for OA , the incidence of OA is expected to rise in years to come. OA causes high direct costs (0.7 % to 1.2 % of the gross national product), and also high indirect costs as a consequence of morbidity and disability and represents one of the diseases with the highest economic impact . The main care provider for many patients with OA is the GP. To improve quality of care for osteoarthritis patients, evidence-based guidelines and a quality indicator set exist in most countries; however, this is not the case in Germany . It has been suggested that conservative management of OA is difficult for physicians and patients, but little is known about the actual management of OA in primary care in Germany. Moreover, there is only limited information on the perspectives of different groups involved in the treatment of OA. For instance, practice nurses play an increasing role in providing care in many health care systems, but their perspective is often ignored. Insight into patients', physicians' and practice nurses' views on management of OA is needed to identify problems concerning quality of care and possibilities for improvement. The aim of our study was to reveal patients' needs, assess their wishes for improvement and to identify obstacles that handicap improvements. In order to implement such improvements, it is important to not only assess the views of patients but also those of doctors and practice nurses. The interview guideline was created according to our hypothesis that patients lack information on the disease, medication and possible approaches and wish for more consultation time. The results of this study should help create interventions for the primary care setting to be evaluated in a subsequent intervention study. Methods A qualitative interview study with general practitioners (GPs), practice nurses and patients with OA was performed according to the guidance for qualitative research. A heterogeneous sample of 20 GPs, 20 practice nurses and 20 patients was stratified by gender and urbanisation level. The GPs had to have a minimum of 5 years experience; the assistants were required to have a minimum of 10 years professional experience. The patients were selected at random from the GPs' computer files by searching for patients with the ICD -code M16.0–16.9 (coxarthrosis) and M17.0–17.5 (gonarthrosis). During their practice visit they were 9" @default.
• W1554031310 created "2016-06-24" @default.
• W1554031310 creator A5089136249 @default.
• W1554031310 date "2008-01-01" @default.
• W1554031310 modified "2023-09-26" @default.
• W1554031310 title "Patients with osteoarthritis in primary care." @default.
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