Skip to main content

Table 4 Adherence to the additional eight quality indicators for knee OA management measured with the case vignettes

From: Educational outreach visits to improve knee osteoarthritis management in primary care

Quality Indicator Adherence intervention group
n/N (%)
Adherence control group
n/N (%)
Comparison intervention-control group
p-value ¥
A. Diagnosis
1.If a patient is clinically diagnosed with knee OA and suffering from pain resistant to conservative treatment with acetaminophen and/or NSAID,
 a/ CT scan should not be used.Ω
144/146
(98.6%)
206/208
(99.0%)
0.720 β
 b/ MRI should not be used.Ω 135/146
(92.5%)
194/208
(93.3%)
0.680
2. If a patient with knee OA has a recurrent clinically evident effusion, then he/she should be further assessed (with aspiration and analysis of synovial fluid) in order to differentiate from inflammation caused by other arthritis. 73/73
(100%)
104/104
(100%)
/
B. Lifestyle/education/devices
3. If a patient has knee OA, then a brace should not be prescribed (except in unicompartmental knee OA with axial deviation).Ω 122/127α
(96.1%)
204/208
(98.1%)
0.280 β
C. Therapy
4. If a patient has knee OA, then exercise therapy should be advised, including at least:  
 a/ muscle strengthening Ω 45/146
(30.8%)
57/208
(27.4%)
0.986
 b/ aerobic exercises Ω 13/146
(8.9%)
20/206
(9.6%)
0.980
5. If a patient has knee OA, then acetaminophen up to 3 g/day should be used as the initial oral analgesic. 58/73
(79.5%)
88/104
(84.6%)
0.353
6. If a patient has knee OA and there is no adequate response on acetaminophen, or there is severe pain and/or inflammation, then oral NSAID should be used. 29/73
(39.7%)
42/104
(40.4%)
0.784
7. If a patient has knee OA, then chondroitin and glucosamine-chondroitin combination products should not be used.Ω 139/146
(95.2%)
192/208
(92.3%)
0.280
8. If a patient has knee OA, then strong opioids (oxymorphone, oxycodone, fentanyl, morphine sulfate) should not be used.Ω 146/146
(100%)
206/206
(100%)
/
  1. Ω The quality indicator is relevant for both cases. The quality indicator adherence is calculated as the sum for both cases
  2. ¥ Results from an additive multivariable logistic regression model using Generalized Estimating Equations (GEE) to handle the correlation between the two results per GP if the quality indicator was relevant for both cases
  3. β A regression models using GEE could not be used due to lack of variability. Only the result of a Fishers exact test is reported
  4. α missing values: n = 19