FRI0645-HPR QUALITY OF DUTCH KNEE OSTEOARTHRITIS CARE: THE PATIENT’S PERSPECTIVE
Authors: Y. Peters, J. Vriezekolk, C. Van den Ende
Journal: Annals of the Rheumatic Diseases (2020)

Background: In the Netherlands over 1.2 million people have OA of which almost half have knee OA. Recently, several international and national guidelines and quality standards have been developed and adopted to improve the quality of knee OA care. Mapping the patient perspective is a valuable and important step to get insight into the current status of the quality of knee OA care and the uptake of the quality of care standards endorsed by current guidelines. Objectives: To investigate the quality of knee osteoarthritis care from the patients’ perspective in the Netherlands. Methods: Members of a large observational prospective cohort (n=622), consisting of people clinically diagnosed or suspected with knee OA, were invited to compete an online survey. Besides demographic characteristics participants were inquired whether they contacted a health care professional(s) in the last year for their knee OA and, to fill in a slightly adapted version of the “OsteoArthritis Quality Indicator (OA-QI) questionnaire. In addition, participants rated the quality of knee osteoarthritis care in the Netherlands on a 10-point scale (1: very poor - 10: excellent), and were invited to make recommendations for knee OA healthcare improvement via open-ended questions. Results: Between September and October 2019, 434 participants completed the survey. Preliminary results show that most participants (78%) contacted one or more health care professional(s) for their knee OA complaints in the last year; most often an exercise and/or physical therapist (53.2%), the general practitioner (43.8%) and/or an orthopedist/orthopedic surgeon (41.5%). Furthermore, there were large variations in self-reported quality indictor achievements (checked “Yes”) with the lowest rate for referral for weight reduction and, the highest rate for advice on managing/living with osteoarthritis (table 1). On average, a score of 6.5 was given by the participants for the quality of knee OA healthcare in the Netherlands. Participants’ suggestions for OA care improvement comprised of, among others, more attention to pain and fatigue symptoms, expanding and researching treatment options, more information on OA, more attention to the personal situation and, improvement of multidisciplinary care. Table 1. Self-reported Quality Indicator achievement Self-reported Indicators Eligible n* Checked “Yes” n(%) Received information about OA 417 310 (74.3) Received Information about treatment 424 252 (59.4) Advised on managing/living with OA 421 313 (74.4) Was offered support on managing/living with OA 421 253 (60.1) Received information about exercise 426 306 (71.8) Was offered a referral for (muscle-strengthening) exercises and exercise activities 423 211 (49.9) Advised to lose weight 303 111 (36.6) Was offered a referral to services for losing weight 247 37 (15.0) Assessment of problems in daily activities 301 89 (29.6) Assessed for walking aid 273 65 (23.8) Assessed for daily living appliances/aids 284 52 (18.3) Assessment of pain 426 240 (56.3) Advised paracetamol 424 312 (73.6) Offered stronger painkillers 421 132 (31.4) Offered anti-inflammatory medicine 422 229 (54.3) Offered joint injection 429 239 (55.7) Conversation about knee replacement surgery 362 223 (61.6) Discussed follow-up appointment to monitor OA and evaluate treatment 427 144 (33.7) * Excluding “not applicable” and “do not remember” Conclusion: There is room for improvement from the patients’ perspective to increase the quality of knee OA care in the Netherlands. References: [1] Østerås N, et al. Arthritis Care Res (Hoboken). 2013 Jul;65(7):1043-51. [2] Østerås N, et al. RMD Open. 2015 Oct 20;1(1):e000136. [3] Blackburn S, Res Involv Engagem. 2016 Mar 17;2:5. Disclosure of Interests: None declared