Article

Osteoarthritis (OA) is the commonest reason for a musculoskeletal
consultation in primary care in older adults. There is evidence that appropriate
advice and management is sub-optimal. The aim of this study was to explore
perceptions and experiences of the treatment and management of hand OA in older
adults. METHODS: Four focus groups were conducted with primary (n = 15) and
secondary (n = 14) care participants aged 50-84 years (mean age 64.9 years; 3
males, 14 females) with a clinical diagnosis of hand OA. Data were tape-recorded,
transcribed and analysed using thematic analysis and constant comparison method.
RESULTS: Participants described a lack of help and information with regards to
management of their hand OA and also a perceived lack of understanding of the
impact of hand OA on the individual. Some received contradictory advice about its
management. Beliefs about treatment efficacy were balanced against perceived and
actual side-effects and tolerance, and such perceptions appeared to influence the
use of alternative therapies. CONCLUSIONS: The study identified a perceived unmet
need in people with hand OA presenting in primary and secondary care. This may be
due to the clinical uncertainty of treatment, lack of high-quality randomised
controlled trials evaluating therapeutic options, and the limited written
information available incorporating the patient experience. The study emphasised
the need to understand patient illness and treatment beliefs.
A better
understanding of illness and treatment beliefs will facilitate the use of
evidence-based approaches in the management of hand OA.

Langue : ANGLAIS