A study analyzing knee osteoarthritis management by general practitioners revealed a predominant focus on X-ray referrals, highlighting the need for increased integration of non-surgical strategies and addressing potential overuse of X-rays in diagnosis.
The following is a summary of “Patterns of knee osteoarthritis management in general practice: a retrospective cohort study using electronic health records,” published in the January 2024 issue of Primary Care by Arslan, et al.
For a study, researchers sought to delineate the trends in knee osteoarthritis (OA) management by general practitioners (GPs) through an examination of routine healthcare data derived from Dutch general practices spanning the period from 2011 to 2019.
Conducted as a retrospective cohort study, the investigation utilized the Integrated Primary Care Information database between 2011 and 2019. A meticulous review of electronic health records (EHRs) was undertaken for a randomly selected cohort of n = 750 knee OA patients, diagnosed either through codified or narrative means. After applying eligibility criteria, a total of n = 503 patients were included in the analysis. The study focused on extracting recorded information related to GPs’ management practices during the six months preceding the diagnosis and extending up to three years post-diagnosis. Subsequently, patterns of management were analyzed to discern prevalent approaches.
The predominant modality of management recorded was X-ray referrals, constituting 63.2% of cases. Following closely were referrals to secondary care (56.1%) and medication prescriptions or advice (48.3%). Conversely, recommendations or referrals to other primary care practitioners, such as physiotherapists, were documented in only one-third of the patients. The least commonly recorded intervention was advice for weight loss, observed in a mere 1.2% of cases. Comparison between patients with and without X-ray referrals revealed that records of medication prescriptions or referrals to other primary care practitioners were more frequent in the former group. In contrast, records of secondary care referrals were less frequent in patients with X-ray referrals. Intriguingly, records of X-ray referrals were often documented in patients with narratively diagnosed knee OA before GPs officially coded the condition in their EHR.
The findings underscored the imperative need for enhanced integration of non-surgical management strategies for knee OA within general practice. Additionally, initiatives to mitigate the overuse of X-rays for knee OA diagnoses in general practice are warranted based on the observed patterns.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02198-z