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Quality of care for OA: the effect of a point-of-care consultation recording template.

Edwards, John J.; Jordan, Kelvin P.; Peat, George; Bedson, John; Croft, Peter R.; Hay, Elaine M.; Dziedzic, Krysia S.

Quality of care for OA: the effect of a point-of-care consultation recording template. Thumbnail


Authors

John J. Edwards

George Peat

John Bedson

Peter R. Croft



Abstract

OBJECTIVE: The aims of this study were to determine the feasibility of introducing a computerized template for identifying quality of care during an OA consultation, describe quality of OA care in practices in which the template was introduced and assess the effect of the template on routinely recorded clinician behaviour in those practices. METHODS: A computerized template to assist the recording of care in consultations for patients with OA was installed in eight general practices. Eligible patients were those =45 years of age consulting for clinical OA during a 6 month period. The main outcomes were frequency of template triggering, achievement of quality indicators during the consultation (assessment of pain and function, assessment for first-line analgesics, provision of information, exercise advice, consideration of physiotherapy referral, weight loss advice) and change in routinely recorded clinician behaviour (diagnostic coding, prescribing, referral, use of radiography, weight records) compared with the 12 months prior to template installation. RESULTS: The template was triggered for 1730 patients. Achievement of indicators ranged from 36% (for consideration of physiotherapy referral) to 63% (for pain assessment), with substantial variability between clinicians. There was an increase in prescription of recommended first-line analgesics following the template installation: paracetamol [odds ratio (OR) 1.49 (95% CI 1.22, 1.82) compared with pre-template] and topical NSAIDs [OR 1.95 (95% CI 1.61, 2.35)]. CONCLUSION: This new template is a feasible tool for capturing data during OA consultations to aid assessment of quality of care. It was associated with significant improvements in recommended care processes. However, strategies are needed to ensure consistent approaches between clinicians. Trial registration. http://www.controlled-trials.com/ISRCTN06984617/mosaics.

Journal Article Type Article
Acceptance Date Aug 21, 2014
Online Publication Date Oct 20, 2014
Publication Date 2015-05
Publicly Available Date Mar 28, 2024
Journal Rheumatology
Print ISSN 1462-0324
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 54
Issue 5
Pages 844-853
DOI https://doi.org/10.1093/rheumatology/keu411
Keywords osteoarthritis, primary care, quality indicator, reminder systems, medical record systems, computerized
PMID 25336538