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Uptake of the NICE osteoarthritis guidelines in primary care: a survey of older adults with joint pain

Healey, Emma Louise; Afolabi, Ebenezer K. ; Lewis, Martyn; Edwards, John J.; Jordan, Kelvin P.; Finney, Andrew; Jinks, Clare; Hay, Elaine M.; Dziedzic, Krysia S.

Uptake of the NICE osteoarthritis guidelines in primary care: a survey of older adults with joint pain Thumbnail


Authors

Ebenezer K. Afolabi

John J. Edwards



Abstract

Background
Osteoarthritis (OA) is a leading cause of pain and disability. NICE OA guidelines (2008) recommend that patients with OA should be offered core treatments in primary care. Assessments of OA management have identified a need to improve primary care of people with OA, as recorded use of interventions concordant with the NICE guidelines is suboptimal in primary care. The aim of this study was to i) describe the patient-reported uptake of non-pharmacological and pharmacological treatments recommended in the NICE OA guidelines in older adults with a self-reported consultation for joint pain and ii) determine whether patient characteristics or OA diagnosis impact uptake.

Methods
A cross-sectional survey mailed to adults aged =45 years (n?=?28,443) from eight general practices in the UK as part of the MOSAICS study. Respondents who reported the presence of joint pain, a consultation in the previous 12 months for joint pain, and gave consent to medical record review formed the sample for this study.

Results
Four thousand fifty-nine respondents were included in the analysis (mean age 65.6 years (SD 11.2), 2300 (56.7%) females). 502 (12.4%) received an OA diagnosis in the previous 12 months. More participants reported using pharmacological treatments (e.g. paracetamol (31.3%), opioids (40.4%)) than non-pharmacological treatments (e.g. exercise (3.8%)). Those with an OA diagnosis were more likely to use written information (OR 1.57; 95% CI 1.26,1.96), paracetamol (OR 1.30; 95% CI 1.05,1.62) and topical NSAIDs (OR 1.30; 95% CI 1.04,1.62) than those with a joint pain code. People aged =75 years were less likely to use written information (OR 0.56; 95% CI 0.40,0.79) and exercise (OR 0.37; 95% CI 0.25,0.55) and more likely to use paracetamol (OR 1.91; 95% CI 1.38,2.65) than those aged <?75 years.

Conclusion
The cross-sectional population survey was conducted to examine the uptake of the treatments that are recommended in the NICE OA guidelines in older adults with a self-reported consultation for joint pain and to determine whether patient characteristics or OA diagnosis impact uptake. Non-pharmacological treatment was suboptimal compared to pharmacological treatment. Implementation of NICE guidelines needs to examine why non-pharmacological treatments, such as exercise, remain under-used especially among older people.

Journal Article Type Article
Acceptance Date Jul 17, 2018
Publication Date Aug 17, 2018
Publicly Available Date Mar 29, 2024
Journal BMC Musculoskeletal Disorders
Print ISSN 1471-2474
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 19
Article Number 295
DOI https://doi.org/10.1186/s12891-018-2196-2
Keywords osteoarthritis, joint pain, general practice, NICE guidelines
Publisher URL https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-018-2196-2