Adherence to stepped care for the management of knee osteoarthritis in the Netherlands
Authors' conclusion
Despite clinical guidelines outlining a SC approach to manage knee OA, only a small proportion of patients of 55 years of age or older with knee complaints have utilized all non-surgical treatment options before being referred for orthopedic consultation in the Netherlands. Most patients consulting an orthopedic surgeon receive conservative treatment modalities, also included in the Dutch clinical guideline on knee symptoms for GPs.
Study context
- Population
- Patients aged ≥55 years with a symptomatic knee before orthopedic consultation, three hospitals, the Netherlands (mean age 66.8 years, 54% female)
- Participants
- 7,874 patients
- Exposure
- Full Stepped Care (SC) vs partial SC vs no SC adherence before orthopedic consultation
- Outcome
- SC adherence prior to orthopedic consultation
Methodological detailsmulticentre (three hospitals), regression analyses
- Multicentre (three hospitals)
- Regression analyses
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Factors associated with arthroplasty as treatment choice
| OR (95% CI) | ||
|---|---|---|
| Longer symptom durationHighest OR | 4.4 (3.7–5.3) | |
| 0.20.5125Odds ratio (log scale) |
Non-operative OA management following orthopedic consultation
- Proportion of patients receiving non-operative OA management
- 71.6%
Factors associated with arthroplasty as treatment choice
- Increasing age, higher BMI, longer symptom duration, greater pain during activity, reduced walking ability and full SC adherence all associated with higher odds of arthroplasty
Original publication
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