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On the waiting list for joint replacement for knee osteoarthritis: are first-line treatment recommendations implemented?
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Health Sciences, Lund University, Lund, Sweden. (Fysioterapi)ORCID iD: 0000-0002-3282-6320
Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
2020 (English)In: Osteoarthritis and Cartilage Open, ISSN 2665-9131, Vol. 2, no 2, article id 100056Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate to what extent individuals participated in guideline-based first-line treatments before being assigned to a wait list for knee replacement for osteoarthritis (OA), and to what extent they were recommended such treatments once on the list. Factors associated with participation in first-line management were also investigated.

Design: All patients on the waiting list ≥ three months for knee replacement due to knee OA (n = 229) at a public hospital in Sweden were invited to participate in this cross-sectional survey study. 136 individuals (mean age 70 ± 9 years, 59% women) answered self-reported questionnaires including demographics, physical activity level, knee function and treatments before and during their time on the waiting list.

Results: Before being referred to the waiting list, 40% had participated in guideline-based OA management (Better management of patients with OsteoArthritis (BOA)), 53% in physiotherapy, 67% in either BOA or physiotherapy whilst 23% of those overweight (BMI≥25) had received weight-management advice. Women had participated in BOA and physiotherapy twice as often as men (51% vs. 25%, p = 0.002 and 66% vs. 34%, p < 0.001) prior to waiting list referral. During their time on the waiting list, only 10% were recommended BOA, 30% physiotherapy and 15% weight-management. 38% of the patients that had never participated in BOA indicated that they were interested in participating while waiting for their knee replacement.

Conclusion: Our results suggest that recommended treatment guidelines for OA may not be adequately implemented in Swedish health-care. Further exploration of implementation barriers and lack of equality of care appears warranted.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 2, no 2, article id 100056
Keywords [en]
Education, Exercise, First-line treatment, Implementation, Joint replacement, Osteoarthritis
National Category
Orthopaedics Physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-178520DOI: 10.1016/j.ocarto.2020.100056PubMedID: 36474591Scopus ID: 2-s2.0-85090572122OAI: oai:DiVA.org:umu-178520DiVA, id: diva2:1517379
Available from: 2021-01-13 Created: 2021-01-13 Last updated: 2023-07-07Bibliographically approved

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Cronström, Anna

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