Osteoarthritis causes substantial morbidity in developed countries. In the UK it is the most prevalent chronic disease among adults aged 65 years and over, affecting 32% of men and 47% of women.1 It is also the most common cause of disability.2 Osteoarthritis is an age-related condition,3 and there is a greater level of need among women and those from more deprived backgrounds.4 Those in poorer socioeconomic groups and women have higher levels of need for hip and knee replacement but receive relatively fewer joint replacements.4–6 Many individuals are living for prolonged periods with severe osteoarthritis.
High-quality primary care is of clear importance for such a prevalent condition that has both major personal and social impact. This has been recognised by the National Institute for Health and Clinical Excellence (NICE), which has recently published guidelines for the care and management of osteoarthritis in adults.7 However, there is little published information on the quality of primary care for osteoarthritis in the UK. US studies have found the quality of osteoarthritis primary care to be suboptimal, with achievement of quality measures ranging from 31% to 64%.8
This study assessed the overall quality of recorded osteoarthritis treatment in primary care in an English county. It also assessed whether the recorded achievement of quality indicators (QIs) was associated with particular patient characteristics linked to the epidemiology and natural history of osteoarthritis, or with practice characteristics.
How this fits in
Osteoarthritis is the most common cause of disability in the UK, but little is known about the quality of primary care for people with osteoarthritis. Quality indicators can be used to measure the extent to which primary care for osteoarthritis meets pre-determined standards. This study found shortfalls in the recorded quality of osteoarthritis primary care. Quality varied by patients’ age and by the severity of osteoarthritis, but not by their postcode deprivation score.
