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Arthritis Management in Primary Care and Adherence to National Guidelines – a Swedish Survey Based on the Canadian Physiotherapists Arthritis Care Questionnaire
Unit of Rehabilitation, Kalmar County Council, Samrehab, Oskarshamn, Sweden.
The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Lund University, Lund, Sweden & FoU Spenshult, Halmstad, Sweden.ORCID-id: 0000-0002-6294-538X
Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS), Biomekanik och biomedicin. Lund University, Lund, Sweden & FoU Spenshult, Halmstad, Sweden.ORCID-id: 0000-0002-8081-579X
2015 (Engelska)Ingår i: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 67, nr Suppl. S10, artikel-id 2385Artikel i tidskrift, Meeting abstract (Refereegranskat) Published
Abstract [en]

Background/Purpose:

For patients with osteoarthritis (OA) physical therapy is recommended first line treatment and performed in primary care while patients with rheumatoid arthritis (RA) may be treated in primary care at disease onset and during stable phases of the disease. This requires updated skills and evidence based knowledge of the physical therapists (PTs) in arthritis treatment. The aim of this study was to explore physical therapy arthritis practice in primary care and to study the application of evidence based care given to patients with OA or RA.

Methods:

All PTs working in primary care in one health care region in Sweden (n=70) were e-mailed a questionnaire (the Canadian Physiotherapists Arthritis Care Survey1) to assess the frequency of current practice, feeling of confidence, educational needs and adherence to national guidelines in managing patients with OA or RA.  The questionnaire was translated and culturally adapted into Swedish according to international recommendations. Interventions supported by national guidelines were compared with reports of treatment modalities in the questionnaire. Mann-Whitney U test, Chi-square test or Fishers Exact test, were used where appropriate, to analyze differences between groups (PT management of patients with OA vs. RA).

Results:

Sixty-four PTs responded (91%), reporting a higher feeling of confidence in assessment, treatment and education for patients with OA than for RA (p<0.001). The total numbers of roles assumed by the PTs were higher in management of OA compared to RA (p<0.001). PTs who assumed a large numbers of roles also reported a higher feeling of confident in assessing OA (p=0.036). PTs who assumed a lower numbers of roles also reported a lower feeling of confidence in RA treatment (p=0.045). The recommendations in the guidelines were reported to be followed by almost all PTs in managing patients with RA and for eight out of eleven treatment modalities for patients with OA. Most PTs did provide joint mobilization and education of proper footwear for patients with OA even though Swedish national guidelines did not recommend this as treatment until further research has proven its effectiveness.

Conclusion:

PTs reported a lower feeling of confidence and to have assumed a lower numbers of roles in managing patients with RA than OA. There was a good adherence to the national guidelines for almost all listed treatment modalities. However, experienced evidence care and national guidelines did not totally agree. The results indicate a need for education in arthritis care, especially in RA.

References:

Li CL, Hurkmans EJ, Sayre EC, Vliet Vlieland TPM (2010). Continuing professional development is associated with increasing physical therapists´ roles in arthritis management in Canada and the Netherlands. Physical Therapy 90:629-42.

Ort, förlag, år, upplaga, sidor
Hoboken, NJ: John Wiley & Sons, 2015. Vol. 67, nr Suppl. S10, artikel-id 2385
Nyckelord [en]
evidence-based practice, management, Osteoarthritis, physical therapy & rheumatoid arthritis (RA)
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:hh:diva-29848DOI: 10.1002/art.39448ISI: 000370860203786OAI: oai:DiVA.org:hh-29848DiVA, id: diva2:875170
Konferens
2015 ACR/ARHP Annual Meeting, San Francisco, CA, USA, November 6-11, 2015
Tillgänglig från: 2015-11-30 Skapad: 2015-11-30 Senast uppdaterad: 2017-12-01Bibliografiskt granskad

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Bergman, StefanBremander, Ann

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