Quality of Community-Based Osteoarthritis Care: A Systematic Review and Meta-Analysis

Autor: Gro Jamtvedt, Kåre Birger Hagen, Nina Østerås, Geir Smedslund
Rok vydání: 2016
Předmět:
Zdroj: Arthritis Care & Research. 68:1443-1452
ISSN: 2151-464X
Popis: Objective To evaluate the state of quality of care for osteoarthritis (OA) by summarizing studies that have assessed the care provided to patients. Methods A systematic review of community-based observational studies of actual clinical practice treating people with OA compared with quality indicators (QIs) was performed. Four databases were searched from January 2000 to November 2015. Two reviewers independently determined study eligibility, assessed risk of bias, and extracted study data. The outcome was adherence to the QIs (pass rate). The overall pass rate (the total number of indicators passed divided by the total number of indicators for which the patients were eligible) was extracted from each study. When at least 50% of the studies had comparable individual QIs, the data were pooled with proportion meta-analyses. Results Fifteen studies comprising 16,103 patients were included, and the median overall pass rate across studies was 41% (range 22-65%). The pooled pass rates for individual QIs were "referral to orthopedic surgeon if no response to other therapy": 59.4% (95% confidence interval [95% CI] 47.5-70.3); "paracetamol or acetaminophen first drug used": 46.0% (95% CI 26.6-66.7); "assessed for pain and/or function": 45.5% (95% CI 33.9-57.6); "referral or recommendation to exercise": 38.7% (28.9-49.5); "offered education and self-management": 35.4% (95% CI 27.8-44.0); and "informed about potential risks if NSAIDs prescribed": 34.1% (95% CI 24.7-44.9). Conclusion There is room for improvement in community-based OA care.
Databáze: OpenAIRE
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