Research ArticleArticle
Formulating Knee Osteoarthritis Management Plans Taking Type 2 Diabetes Into Account: Qualitative Study of Arthritis Therapists Using Theoretical Domains Framework
Lauren K. King, Esther J. Waugh, Crystal MacKay, Ian Stanaitis, Owen Krystia, Jane Stretton, Susan Ross, Shawn Brady, Alanna Weisman, Lorraine Lipscombe and Gillian A. Hawker
The Journal of Rheumatology September 2022, jrheum.220535; DOI: https://doi.org/10.3899/jrheum.220535
Lauren K. King
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Esther J. Waugh
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Crystal MacKay
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Ian Stanaitis
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Owen Krystia
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Jane Stretton
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Susan Ross
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Shawn Brady
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Alanna Weisman
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Lorraine Lipscombe
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Gillian A. Hawker
This study was funded by a Project Grant from the Canadian Institutes of Health Research (CIHR). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. LKK is supported by a CIHR doctoral research award and the University of Toronto Department of Medicine Eliot Phillipson clinician scientist training program. GAH has received research support as the Sir John and Lady Eaton Professor and Chair of Medicine, Department of Medicine, University of Toronto. L.K. King, MD, MSc, G.A. Hawker, MD, MSc, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital; E.J. Waugh, PhD, BScPT, Department of Physical Therapy, University of Toronto; C. MacKay, PhD, BScPT, Department of Physical Therapy, University of Toronto, and West Park Healthcare Centre; I. Stanaitis, BMSc, Women's College Research Institute, Women's College Hospital; O. Krystia, BASc, University of Toronto; J. Stretton, MSW, Women's College Research Institute, Women's College Hospital; S. Ross, MSc, Arthritis Rehabilitation and Education Program, Arthritis Society Canada; S. Brady, MSc, BScPT, Arthritis Rehabilitation and Education Program & Innovation, Arthritis Society Canada; A. Weisman, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital; L. Lipscombe, MD, MSc, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, and Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. LL receives salary support as the Director of the Novo Nordisk Network for Healthy Populations, University of Toronto. SR and SB are employees of the Arthritis Society Canada. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. L.K. King, Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada. Email: l.king@mail.utoronto.ca. Accepted for publication August 17, 2022.
Abstract
Objective Delivering person-centered care in individuals with knee osteoarthritis (OA) necessitates consideration of other chronic conditions that frequently co-occur. We sought to understand the extent to which arthritis therapists consider type 2 diabetes mellitus (T2DM) when treating persons with knee OA and concomitant T2DM, and barriers to doing so.
Methods We conducted 18 semistructured telephone interviews with arthritis therapists working within a provincially funded arthritis care program (Arthritis Society Canada) in Ontario, Canada. We first analyzed interviews deductively using the Theoretical Domains Framework (TDF) to comprehensively identify barriers and enablers to health behaviors. Then, within TDF domains, we inductively developed themes.
Results We identified 5 TDF domains as prominently influencing the behavior of arthritis therapists considering concomitant T2DM when developing a knee OA management plan. These were as follows: therapists' perceived lack of specific knowledge around comorbidities including diabetes; the lack of breadth in skills in behavioral change techniques to help patients set and reach their goals, particularly when it came to physical activity; variable intention to factor a patient's comorbidity profile to influence their treatment recommendations; the perception of their professional role and identity as joint focused; and the environmental context with lack of formalized follow-up structure of the current Arthritis Society Canada program that limited sufficient patient monitoring and follow-up.
Conclusion Within the context of a Canadian arthritis program, we identified several barriers to arthritis therapists considering T2DM in their management plan for persons with knee OA and T2DM. These results can help inform strategies to improve person-centered OA care and overall health outcomes.
Log in using your username and password
Purchase access
You may purchase access to this article. This will require you to create an account if you don't already have one.
In this issue
The Journal of Rheumatology
Vol. 50, Issue 1
1 Jan 2023
Formulating Knee Osteoarthritis Management Plans Taking Type 2 Diabetes Into Account: Qualitative Study of Arthritis Therapists Using Theoretical Domains Framework
Lauren K. King, Esther J. Waugh, Crystal MacKay, Ian Stanaitis, Owen Krystia, Jane Stretton, Susan Ross, Shawn Brady, Alanna Weisman, Lorraine Lipscombe, Gillian A. Hawker
The Journal of Rheumatology Sep 2022, jrheum.220535; DOI: 10.3899/jrheum.220535
Formulating Knee Osteoarthritis Management Plans Taking Type 2 Diabetes Into Account: Qualitative Study of Arthritis Therapists Using Theoretical Domains Framework
Lauren K. King, Esther J. Waugh, Crystal MacKay, Ian Stanaitis, Owen Krystia, Jane Stretton, Susan Ross, Shawn Brady, Alanna Weisman, Lorraine Lipscombe, Gillian A. Hawker
The Journal of Rheumatology Sep 2022, jrheum.220535; DOI: 10.3899/jrheum.220535
