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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