Article Figures & Data
Figures
- Figure 1.
Recruitment of primary healthcare (PHC) organizations and providers.
Tables
- Table 1.
Scoring of arthritis best practices for 3 case scenarios [moderate knee osteoarthritis (OA), early and late rheumatoid arthritis (RA)].
Best Practices Moderate Knee OA Early RA Late RA Education Provided education or educational materials or contacts for further information (e.g., support groups, The Arthritis Society, Arthritis Society help line (1 800 line) or website, Arthritis Self Management Program) 1 1 1 Exercise/PT Provided or recommended exercise or physical activity or referred to an exercise program or to a physiotherapist 1 1 1 Joint protection/OT/assistive devices Provided instruction in joint protection or energy conservation techniques or recommended or referred to an occupational therapist. Provided a device or recommended or referred to rehabilitation specialist for assistive devices (e.g., canes, crutches, or walkers to improve ambulation) 1 1 1 SW/social support Inquired about or discussed social support and coping strategies, provided or recommended or referred to a social worker/psychologist, psychiatrist, or mental health worker/counselor 1 1 Weight management Provided information on maintaining a healthy weight, healthy eating, nutrition, or assessed body mass index/waist circumference/weight 1 Analgesics Prescribed or recommended or referred for analgesics (e.g., acetaminophen, glucosamine, capsaicin cream, acupuncture) 1 NSAID Considered, prescribed, or referred for nonsteroidal antiinflammatory drugs (NSAID), advancing to higher doses as necessary 1 1 1 Intraarticular injections Considered, prescribed, or referred for intraarticular corticosteroids or hyaluronans 1 Rheumatology referral Discussed or considered or made a referral to an arthritis specialist (rheumatologist, internist) 1 1 DMARD Discussed or recommended or prescribed or referred for a disease-modifying antirheumatic drug (DMARD) 1 1 Orthopedics Discussed or considered or made a referral to an orthopedic surgeon 1 1 Total points 8 7 8 -
PT: physical therapy; OT: occupational therapy; SW: social worker; NSAID: nonsteroidal antiinflammatory drugs; DMARD: disease modifying antirheumatic drugs.
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- Table 2.
Total best practices scores at baseline and 6 months post-workshop for early and late RA and moderate knee OA based on discipline (n = 275). Best possible score is 7 for early RA and 8 for late RA and moderate knee OA.
Discipline (n) Early RA, mean (SD) Late RA, mean (SD) Moderate Knee OA, mean (SD) Baseline* 6 Months Baseline* 6 Months Baseline* 6 Months Physicians (60) 2.90 (1.62) 3.13 (1.85) 3.32 (1.42) 3.60 (2.02) 3.71 (1.98) 3.93 (2.16) Nurse practitioners (30) 3.27 (1.74) 4.17 (1.70)** 3.43 (1.65) 4.69 (1.67)** 3.50 (1.70) 4.76 (1.64)** Rehabilitation therapists (61) 2.74 (1.30) 3.31 (1.38)** 2.10 (1.13) 2.48 (1.10)** 3.11 (1.49) 3.58 (1.60)** Nursing (84) 1.75 (1.65) 2.12 (1.80) 1.33 (1.43) 1.61 (1.54) 2.02 (1.74) 2.24 (1.96) Other (36) 0.86 (1.25) 0.97 (1.32) 0.78 (1.05) 0.78 (1.12) 1.22 (1.40) 1.28 (1.50) Total scores 2.28 (1.71) 2.69 (1.89)** 2.11 (1.65) 2.47 (1.95)** 2.71 (1.90) 3.06 (2.13)** - Table 3.
Percentage (number) of providers recommending specific interventions at baseline and 6 months for 3 case scenarios (n = 275).
Intervention Early RA Late RA Moderate Knee OA Baseline 6 Months Baseline 6 Months Baseline 6 Months Education 31.0 (84) 48.7 (132)* 32.1 (86) 50.4 (135)* 22.2 (60) 41.9 (113)* PT/exercise 58.3 (158) 57.6 (156) 57.1 (153) 53.4 (143) 66.3 (179) 66.3 (179) OT/joint protection/energy conservation 38.0 (103) 45.0 (122)* 45.5 (122) 54.1 (145)* 30.4 (82) 35.6 (96) Weight management/healthy eating — — — — 4.4 (12) 17.4 (47)* SW/social support 23.3 (63) 34.0 (92)* 47.4 (127) 56.0 (150)* — — Analgesics — — — — 24.8 (67) 27.4 (74) NSAID 27.3 (74) 19.2 (52)* 18.3 (49) 13.1 (35)* 25.2 (68) 20.4 (55) Intraarticular injections — — — — 12.2 (33) 15.9 (43) DMARD 7.4 (20) 9.6 (26) 11.9 (32) 15.7 (42)* — — Referral to rheumatology 43.2 (117) 54.6 (148)* 53.7 (144) 59.7 (160) — — Referral to orthopedics — — 2.2 (6) 3.4 (9) 22.6 (61) 21.9 (59) -
↵* p < 0.05, McNemar’s test. PT: physical therapy, OT: occupational therapy; SW: social worker; RA: rheumatoid arthritis; OA: osteoarthritis; NSAID: nonsteroidal antiinflammatory drugs; DMARD: disease modifying antirheumatic drugs.
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- Table 4.
Comparison of providers at baseline and at 6 months followup: satisfaction, confidence, and perceived barriers.
Characteristics No. Baseline, mean (SD) 6 Months, mean (SD) p Satisfaction with ability to deliver arthritis care† 221 4.9 (2.2) 6.3 (1.8) < 0.01* Confidence† Musculoskeletal examination (GP, PT, OT, NP, nurses only) 189 5.4 (2.5) 6.3 (2.4) < 0.01* Intraarticular injection (GP only) 51 5.4 (3.3) 5.9 (3.2) 0.05* Initiating DMARD (GP only) 51 3.1 (2.3) 3.8 (2.3) 0.03* NSAID (GP, NP only) 71 8.2 (1.5) 8.5 (1.4) 0.02* Arthritis management (all) 263 6.2 (2.5) 7.1 (2.2) < 0.01* Perception of barriers (1 or more) to PT, % (n) 77.6 (204) 25.1 (66) < 0.01** OT, % (n) 71.5 (188) 29.7 (78) < 0.01** SW, % (n) 76.4 (201) 35.4 (93) < 0.01** Rheumatologist 91.6 (241) 10.3 (27) < 0.01**
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