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Table 3 Information in GPs’ referral letters of patients to orthopaedic surgeon during pre- and post-implementation

From: Improving osteoarthritis management in primary healthcare: results from a quasi-experimental study

 

% referrals that included

this information during

  

Items considered relevant to be included in GPs’ referral letters:

Information on …

pre-implementation

(n = 86)

post-implementation

(n = 103)

OR (95% CI) for reporting this information

p-valuea

Results from a clinical examination

45

51

1.2 (0.69, 2.18)

0.482

Restricted joint range of motion

35

30

0.8 (0.43, 1.48)

0.484

Joint malalignment

7

11

1.6 (0.56, 4.51)

0.379

Reduced joint stability

9

12

1.3 (0.50, 3.31)

0.602

Skin conditions, if relevant for potential surgeryb

0

3

6.0 (0.31, 118.3)

0.111

Affection of walking ability

64

53

0.6 (0.35, 1.12)

0.111

Eventual use of walking aidsb

6

6

1.0 (0.31, 3.19)

0.997

The activity level

55

53

1.0 (0.54, 1.69)

0.863

Health related quality of life

10

8

0.7 (0.27, 1.96)

0.519

The pain level

92

80

0.3 (0.11, 0.76)

0.012

The duration of pain symptoms

53

81

3.6 (1.89, 6.89)

< 0.001

Eventual progression of pain

51

70

2.2 (1.22, 4.03)

0.009

Night pain

44

46

1.0 (0.60, 1.89)

0.842

Conventional radiograph (CR) being taken

57

57

1.0 (0.57, 1.81)

0.966

Magnetic resonance image (MRI) being taken

47

49

1.1 (0.61, 1.93)

0.781

The CR and MRI image(s) being recentc

84

84

1.0 (0.45, 2.13)

0.967

Used physiotherapy

22

31

1.2 (0.65, 2.33)

0.515

Used supervised exercise

14

21

1.7 (0.77, 3.62)

0.190

Having received information on the OA disease and treatment alternativesb

2

4

1.5 (0.32, 7.37)

0.597

Having participated in an OA education programmeb

1

4

2.6 (0.40, 16.7)

0.321

Paracetamol use

41

45

1.2 (0.66, 2.10)

0.584

NSAID use

62

56

0.8 (0.45, 1,44)

0.460

Topical NSAID useb

5

2

0.5 (0.09, 2.18)

0.322

Opioid use

35

27

0.7 (0.34, 1.30)

0.253

Used non-surgical treatment alternatives for three to six months

13

15

1.2 (0.50, 2.68)

0.725

Overweight or body mass index

12

9

0.7 (0.28, 1.88)

0.512

Having tried weight reduction, if relevantb

6

1

0.2 (0.03, 1.35)

0.101

Smoking status

22

7

0.3 (0.12, 0.72)

0.007

Having tried to stop smoking, if relevantb

7

2

0.1 (0.03, 0.41)

0.001

Comorbidity

86

76

0.5 (0.24, 1.08)

0.078

Current medications

91

86

0.7 (0.26, 1.64

0.362

  1. HP Health professional, NSAIDS Non-Steroidal Antiinflammatory Drugs, OA Osteoarthritis, OA-QI v2 OsteoArthritis Quality Indicator questionnaire version 2, QI Quality indicator
  2. a To account for multiple analyses testing, a Bonferroni correction of the p-value was done (p = 0.0016)
  3. b Analyzed using logistic regression with the Firth procedure for bias reduction in rare events
  4. c Recent was defined as within the past 12 months
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BMC Musculoskeletal Disorders

ISSN: 1471-2474

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