RT Journal Article SR Electronic T1 The Hip and Knee Book: developing an active management booklet for hip and knee osteoarthritis JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e64 OP e82 DO 10.3399/bjgp10X483166 VO 60 IS 571 A1 Nefyn H Williams A1 Elvis Amoakwa A1 Kim Burton A1 Maggie Hendry A1 Ruth Lewis A1 Jeremy Jones A1 Paul Bennett A1 Richard D Neal A1 Glynne Andrew A1 Clare Wilkinson YR 2010 UL http://bjgp.org/content/60/571/e64.abstract AB Background The pain and disability of hip and knee osteoarthritis can be improved by exercise, but the best method of encouraging this is not known.Aim To develop an evidence-based booklet for patients with hip or knee osteoarthritis, offering information and advice on maintaining activity.Design of study Systematic review of reviews and guidelines, then focus groups.Setting Four general practices in North East Wales.Method Evidence-based messages were developed from a systematic review, synthesised into patient-centred messages, and then incorporated into a narrative. A draft booklet was examined by three focus groups to improve the phrasing of its messages and discuss its usefulness. The final draft was examined in a fourth focus group.Results Six evidence-based guidelines and 54 systematic reviews were identified. The focus groups found the draft booklet to be informative and easy to read. They reported a lack of clarity about the cause of osteoarthritis and were surprised that the pain could improve. The value of exercise and weight loss beliefs was accepted and reinforced, but there was a perceived contradiction about heavy physical work being causative, while moderate exercise was beneficial. There was a fear of dependency on analgesia and misinterpretation of the message on hyaluranon injections. The information on joint replacement empowered patients to discuss referral with their GP. The text was revised to accommodate these issues.Conclusion The booklet was readable, credible, and useful to end-users. A randomised controlled trial is planned, to test whether the booklet influences beliefs about osteoarthritis and exercise.