Patients' perceptions of the treatment and management of hand osteoarthritis: a focus group enquiry

Abstract

Purpose. Osteoarthritis (OA) is the commonest reason for a musculoskeletal consultation in primary care in older adults. There is evidence that appropriate advice and management is sub-optimal. The aim of this study was to explore perceptions and experiences of the treatment and management of hand OA in older adults.

Methods. Four focus groups were conducted with primary (n == 15) and secondary (n == 14) care participants aged 50–84 years (mean age 64.9 years; 3 males, 14 females) with a clinical diagnosis of hand OA. Data were tape-recorded, transcribed and analysed using thematic analysis and constant comparison method.

Results. Participants described a lack of help and information with regards to management of their hand OA and also a perceived lack of understanding of the impact of hand OA on the individual. Some received contradictory advice about its management. Beliefs about treatment efficacy were balanced against perceived and actual side-effects and tolerance, and such perceptions appeared to influence the use of alternative therapies.

Conclusions. The study identified a perceived unmet need in people with hand OA presenting in primary and secondary care. This may be due to the clinical uncertainty of treatment, lack of high-quality randomised controlled trials evaluating therapeutic options, and the limited written information available incorporating the patient experience. The study emphasised the need to understand patient illness and treatment beliefs. A better understanding of illness and treatment beliefs will facilitate the use of evidence-based approaches in the management of hand OA.

Keywords:

• Hand osteoarthritis
• management

Acknowledgements

The authors would like to thank Professor Elaine Hay and Dr. Mark Porcheret for their help recruiting the participants, the administrative and health informatics staff at Keele University's Arthritis Research UK Primary Care Centre and the participants for taking part in the study.

Declaration of interest: The study was supported financially by a Programme Grant awarded by the Medical Research Council, UK (grant code: G9900220]], the NIHR grants funding scheme and Support for Science funding secured by the North Staffordshire Primary Care Research Consortium for NHS service support costs. Krysia Dziedzic was supported by a grant from Arthritis Research UK. The authors declare that they have no conflict of interests.