Access and perceived need for physical and occupational therapy in chronic arthritis

Abstract

Purpose. Physical and occupational therapy are beneficial for persons with chronic arthritis; however, access is problematic. The goal was to examine issues related to access to these services for patients with chronic arthritis.

Methods. We used two data sources: 1) questionnaires sent to a random sample of 600 family physicians and to all 85 rheumatologists in the province of Quebec; and 2) interviews of 211 patients with physician-confirmed chronic arthritis recruited from 34 primary care settings in Quebec.

Results. Only 11.5% of family physicians and 31.7% of rheumatologists referred patients with rheumatoid arthritis (RA) to rehabilitation, whereas 60.4% of family doctors referred patients with osteoarthritis. Only 26.1% of patients felt that they required rehabilitation and this was associated with lower self-efficacy (OR: 0.84, 95% CI: 0.72, 0.99) and higher educational level (OR: 2.10, 95% CI: 1.01, 4.36).

Conclusion. Family physicians are less likely to refer patients with RA to therapy. Only about a quarter of patients with chronic arthritis treated in primary care perceived the need for these services. Efforts to improve arthritis care should address education of physicians and patients regarding the benefits of rehabilitation and there should be efforts to increase therapy resources in order to enhance access.

Keywords:

• Physical therapy
• occupational therapy
• arthritis

Declaration of Interest: This study was funded by the Canadian Institutes for Health Research and by the Canadian Initiative for Outcomes in Rheumatoid Arthritis (CIORA). Dr. Ehrmann Feldman was supported by the Arthritis Society and is currently supported by the Fonds de la recherche en santé du Québec and Université de Montréal, School of Rehabilitation. Dr. Sasha Bernatsky is a Canadian Arthritis Network Scholar and is supported by the Canadian Institutes of Health Research, the Fonds de la recherche en santé du Québec (FRSQ), and the McGill University Health Centre Research Institute and Department of Medicine. We acknowledge the support of the Agence de la santé et des services sociaux de Montréal, Direction de Santé Publique.