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Table 3 Statements for inclusion in the model OA consultation

From: Developing a model osteoarthritis consultation: a Delphi consensus exercise

Statement1

No. (%) GP Group would include (n = 15)

No. (%) Patient Group would include (n = 14)

The GP:2

  

Encourages the patient to give a full account of the problem(s), including the reason for coming today

15 (100)

11 (79)

Finds out how long the patient has had the knee problem for and whether the problem comes and goes

14 (93)

12 (86)

Asks specific questions about the amount and type of any pain

14 (100)

11 (79)

Asks about other knee symptoms such as stiffness, locking and giving way

13 (93)

12 (86)

Asks about problems with mobility, such as walking, going up and down stairs, and getting in and out of a chair

13 (93)

9 (64)

Asks if, and how, the knee problem affects activities such as work, hobbies, sports and general leisure activities

14 (100)

7 (50)

Asks about previous problems with the knee, knee operations, knee injections

13 (93)

11 (79)

Asks about problems with other joints, especially the other knee and the hips

14 (93)

8 (62)

Asks about the patient’s ideas, concerns, fears and feelings about the problem

14 (93)

7 (54)

Asks if the patient has tried anything to help the problem, and if yes, what/how used/how effective

15 (100)

12 (92)

Checks if there is anything in the patient’s story to suggest a fracture, cancer, inflammatory or septic arthritis

14 (93)

7 (54)

Examines the knee joint and surrounding tissues

15 (100)

11 (85)

Informs the patient that the most likely reason for the problem is osteoarthritis and explains the reason(s) for coming to this diagnosis

15 (100)

12 (92)

Gives a brief explanation of osteoarthritis

14 (93)

12 (92)

Asks if the patient has any unanswered questions

15 (100)

8 (57)

Hands the guidebook to the patient with the advice to read it

14 (93)

8 (62)

Encourages the patient to consider the use of “NICE core treatments”, increased physical activity/muscle strengthening exercises/dietary changes to lose weight, if needed

14 (93)

10 (77)

Emphasises, when relevant, the benefit of losing weight: that if weight is lost then the pain reduces

14 (93)

10 (77)

Emphasises, when relevant, the benefit of exercise in helping to lose weight in addition to the benefits for osteoarthritis

14 (93)

8 (62)

Enquires about the patient’s need for painkillers

15 (100)

13 (100)

Recommends the use of paracetamol and/or topical NSAIDs (creams or ointments) before the use of other painkillers

15 (100)

13 (100)

Summarises the management plan and re-checks that it is acceptable to the patient

14 (93)

9 (64)

Advises the patient to make a follow up appointment with the specially trained healthcare professional

15 (100)

13 (93)

Uses free-text to record the consultation in the paper/electronic records

14 (93)

8 (67)

In addition to statement above records coded data on the; i) diagnosis and ii) main elements of the consultation, such as the level of pain, the BMI and advice to exercise

15 (100)

10 (77)

  1. 1 Statement in bold if 90% or more agreement in BOTH groups.
  2. 2 “The GP” is the stem for all the statements.