Table 4

Statements excluded from the model OA consultation
Statement No. (%) GP group would include (n = 15) No. (%) Patient group would include (n = 14)
The GP:*
Assesses the degree of pain using a formal measure, such as rating the pain on a scale from 0 to 10 1 (7) 8 (57)
Assesses the extent of mobility problems using a formal measure, such as a rating scale from 0 to 10. 1 (7) 7 (50)
Asks about a family history of joint problems 6 (43) 4 (29)
Asks about jobs which may have affected/caused the knee problem, such as those involving a lot of kneeling (for example, carpet fitter, cleaner, joiner, electrician) 9 (64) 5 (36)
Asks about the patient’s expectations of the consultation 10 (67) 4 (31)
Asks which problem, concerning the knee, the patient wants help with most, for example pain, stiffness or climbing the stairs 9 (60) 5 (38)
Asks about who the patient has seen, or asked for help from, about the problem 10 (71) 6 (46)
Assesses the patient’s mood for symptoms of anxiety and depression 8 (53) 1 (8)
Screens the patient for depression using a formal depression screening tool 0 (0) 0 (0)
Asks about other conditions, such as diabetes, heart or kidney disease, which might affect the management of the knee problem 10 (67) 9 (64)
Asks about circumstances, such as unemployment and financial hardship, which might affect the management of the knee problem 5 (33) 0 (0)
Assesses the knee joint by general observation of the patient’s walking pattern, mobility and footwear 13 (87) 9 (69)
Performs a specific test, such as a timed walk test, to assess function 0 (0) 3 (21)
Examines the other knee, hips and hands for signs of osteoarthritis 11 (73) 10 (71)
If not recently done, measures weight and height to calculate the body mass index 6 (40) 6 (46)
Undertakes a full examination of the locomotor system (of the joints and muscles) 0 (0) 4 (33)
Enquires about the patient’s views and understanding of osteoarthritis 13 (87) 9 (75)
In addition to giving a brief explanation explains the likely cause of osteoarthritis 4 (27) 9 (69)
In addition to giving a brief explanation explains the likely outcome for people with osteoarthritis 9 (60) 8 (62)
Explores the patient’s understanding of the information given, and their reaction/beliefs/feelings about it 8 (53) 8 (62)
Tells the patient that they are central to the management of their own condition: that self-management of osteoarthritis is necessary and important 13 (87) 11 (85)
Explains that the central role of the primary healthcare team in the management of osteoarthritis is to support and guide self-management 7 (47) 9 (69)
Explains the purpose of managing osteoarthritis to: improve understanding, reduce pain, improve mobility and reduce the risk of it getting worse 9 (60) 12 (86)
Explains the approach to the treatment of osteoarthritis recommended by NICE 3 (20) 8 (62)
In addition to handing out the guidebook highlights sections in the guidebook relevant to the patient’s problem 6 (40) 6 (46)
Asks if the patient has any views/preferences for what treatment they might want to consider next, and, if they do, what they are 12 (80) 6 (43)
Takes an “exercise history”: the patient’s attitude to taking exercise/physical activity/exercises and their experience of these 9 (60) 6 (43)
Takes a “weight history”: the patient’s attitude to losing weight and their prior experience of doing this 7 (47) 9 (69)
Indicates, if the patient is overweight, where they are on a body mass index chart 7 (47) 9 (69)
Explains that exercise may cause muscle soreness initially and that the benefits of exercise may not be immediate 9 (60) 5 (38)
Explains the risks and benefits of painkillers 11 (73) 6 (50)
Discusses with the patient whether any other extra treatment needs to be considered 7 (47) 8 (67)
Discusses appropriate referrals, for example to; physiotherapy, occupational therapy, podiatry, social services, community pharmacy, district nursing service or work support services 8 (53) 10 (71)
Discusses the option of joint replacement surgery in patients with established severe pain, or severe functional limitation, in addition to core treatments and painkillers 7 (47) 7 (54)
Formulates with the patient a self-management plan 11 (73) 10 (77)
Explains when the patient should re-consult the GP 11 (73) 8 (57)

* “The GP” is the stem for all the statements.

Porcheret et al.

Porcheret et al. BMC Musculoskeletal Disorders 2013 14:25   doi:10.1186/1471-2474-14-25

Open Data