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%) | / |
