Journal
LANCET REGIONAL HEALTH-WESTERN PACIFIC
Volume 12, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.lanwpc.2021.100187
Keywords
osteoarthritis; general practice; knee; hip
Funding
- AstraZeneca Pty Ltd (Australia)
- Australian Government Department of Health
- Novartis Pharmaceuticals Australia Pty Ltd
- Seqirus (Australia) Pty Ltd
- Sanofi-Aventis Australia Pty Ltd
- Australian Government Department of Veterans' Affairs
- AbbVie Pty Ltd
- Merck, Sharpe and Dohme (Australia) Pty Ltd
- Pfizer Australia
- National Prescribing Service
- GlaxoSmithKline Australia Pty Ltd
- Bayer Australia Ltd
- Janssen-Cilag Pty Ltd
- Abbott Australasia Pty Ltd
- Wyeth Australia Pty Ltd
- Roche Products Pty Ltd
- Aventis Pharma Pty Ltd.
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translational Research in Musculoskeletal Pain [1079078]
- NHMRC Investigator Fellowship [1174431]
- NHMRC Senior Principal Research Fellowship [1082138]
- NHMRC Early Career Fellowship [1163058]
- NHMRC Senior Research Fellowship [1154217]
- National Health and Medical Research Council of Australia [1082138, 1174431, 1163058] Funding Source: NHMRC
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The study showed that GPs in Australia are increasingly managing knee and hip OA, with low utilization of recommended non-pharmacological treatments and high rates of imaging, medication, and surgical referrals. Strategies are needed to optimize lifestyle management and reduce low-value care in OA management.
Background: We aimed to describe trends in knee and hip OA management by general medical practitioners (GPs) in Australia. Methods: We analysed cross-sectional survey data from the Bettering the Evaluation and Care of Health (BEACH) program (1,0 00 randomly-selected GPs annually recording 100 consecutive patient encounters) over two periods: Period one April 1, 2005-March 31, 2010 and period two April 1, 2010-March 31, 2016. This included data from 10,738 GPs and 1,073,800 patient encounters with 6,565 GPs and 9,196 patient encounters for hip/knee OA. Data were summarized using descriptive statistics and 95% confidence intervals around point estimates. Findings: Rate of knee OA problems managed by GPs increased in period two (7.1 (6.9-7.4) vs 6.2 (95% CI 6.0-6.5) per 1,000 all encounters), with a similar trend for hip OA. Encounter rates rose for some subgroups but remained stable for vulnerable subgroups. Although use of Medicare chronic disease management items, referral to allied health professionals and advice/education and lifestyle management (knee OA) increased, rates remained low. Use of MRI imaging rose. Overall medication rates were stable but substantially higher than non-pharmacological treatments. Declining reliance on non-steroidal anti-inflammatory drugs and glucosamine and increased reliance on paracetamol (knee OA) and opioids were demonstrated. Interpretation: GPs in Australia are more frequently managing knee and hip OA. While small changes in GP management actions occured, rates of recommended first-line non-pharmacological treatments remained low and imaging, medications, and surgical referral rates high. Strategies are needed to optimise lifestyle management and reduce low-value care, with attention to healthcare disparities. (C) 2021 The Authors. Published by Elsevier Ltd.
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