An analysis of primary care physiotherapy management of knee osteoarthritis (OA) in an Australian setting has shown that while the level of treatment didn’t meet minimum clinical practice guidelines, participant improvement at three months reached minimally important change thresholds for patient-reported measures and satisfaction was high.

Evidence-based clinical practice guidelines and multidisciplinary programs for physiotherapy management of knee OA have been implemented in the public healthcare sector but are lacking in the private sector, say the researchers, led by Associate Professor Justine Naylor at The University of New South Wales and at Liverpool Hospital in Sydney’s south-west.

The primary aim of the study was to determine the alignment between treatment provided and guideline-based management.

Secondary aims included capturing any improvement reported by the patients and treatment satisfaction.

The researchers also collected data on whether patient-reported outcome measures (PROMS) were routinely used.

The study used a couple of assessments (the Knee injury OA Outcome Score (pdf) and the Routine Assessment Patient Index 3) at baseline and three months in 26 adults aged 45 years and older at nine primary care physiotherapy practices.

Patient satisfaction with their treatment was also recorded at three months.

Treatment details and the use of PROMS were obtained from the participating practices from an audit of the patient records as well as through patient interviews.

All of the patients were prescribed at least one appropriate exercise, 42 per cent received OA education and 12 per cent received weight management advice.

However, no PROMS were used for assessment or monitoring, and the care provided did not meet minimum criteria per clinical practice guidelines.

The researchers note that the data provided useful insights and would inform future strategies for improvements to care delivery.

Access the research paper here.