Candidacy and the Pathway to Total Knee Replacement: A Qualitative Study
O’Brien, P.* (1); Bunzli, S. (1); Ayton, D. (2); Dowsey, M. (1); Gunn, J. (3); Manski Nankervis, J. (3)
(1) Department of Surgery, The University of Melbourne, St Vincent’s Hospital Melbourne, Australia.
(2) Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Australia.
(3) Department of General Practice, The University of Melbourne, Australia
Objectives: General practitioners (GPs) are often the first health professionals to assess patients with osteoarthritis (OA). Despite clinical guideline recommendations for non-surgical intervention as first-line therapies, the most frequent referral from a GP for a person with knee OA is to an orthopaedic surgeon. The aim of this study was to explore the experience of patients with knee OA in general practice, their perceptions of their condition, their access to, and use of non-surgical interventions and the factors that influence decisions to progress to total knee replacement TKR.
Methods: This paper describes a qualitative investigation using semi-structured interviews involving 27 patients with knee OA who were on a waiting list to undergo a TKR at a public hospital in Melbourne, Australia. The Candidacy framework was selected as a lens to examine the factors driving health care access. Interview questions and data analysis were structured on the seven Candidacy domains. Data were analysed using a framework analysis approach involving deductive and inductive coding.
Results: Participants were able to assert their need for medical treatment by articulating the significant impacts that OA was having on their quality of life. Participants acknowledged the important role that GPs played as information sources, reported they rarely received information about non-surgical interventions.
Conclusions: Patients with knee OA require support to navigate allied health services as well as improved information provision on the prognosis of OA, pain management and the benefits of exercise. GPs could play an important role in facilitating uptake of non-surgical interventions.
[pdf-embedder url=”https://opus-tjr.org.au/wp-content/uploads/2019/04/OBrien-P_poster.pdf” title=”O’Brien P_poster”]
For more information about this abstract, please contact:
Penny O’Brien, Department of Surgery, The University of Melbourne and St Vincent’s Hospital Melbourne
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