title: Quality of care for people with osteoarthritis: a qualitative study.
abstract: OBJECTIVE
  The overall aim of this qualitative study was to explore within primary care the experiences of management and care of individuals with end-stage lower limb osteoarthritis who are on the waiting list for joint replacement.
  
  
  BACKGROUND
  Osteoarthritis, one of the most common chronic diseases, causes loss of physical function and severe pain among sufferers. Improving quality of care and service provision for individuals with chronic diseases is high on the UK's NHS agenda.
  
  
  METHODS
  Data were collected by semi-structured qualitative interviews with 21 individuals with osteoarthritis who were waiting for a hip or knee replacement operation. Interviews were analysed using framework analysis.
  
  
  RESULTS
  Participants had been suffering with osteoarthritis for between seven months and 38 years. The management by health professionals for people on the waiting list for joint replacement was minimal. However, participants spoke of 'hiding' their symptoms from health professionals and were trying to 'self-manage' their symptoms. Families became more involved in helping individuals with osteoarthritis to manage with everyday life.
  
  
  CONCLUSIONS
  Management of individuals' osteoarthritis while on the waiting list needs to be given consideration by health professionals in primary and secondary care. Health professionals need to be working with each other to provide more comprehensive care across the primary and secondary care interface.
  
  
  CONCLUSIONS
  Case managers or community matrons could be identified as the co-ordinator and assessor of the needs of patients with osteoarthritis so as to try and improve pain management and service provision for these individuals especially while on the waiting list.
authors.affiliation: School of Nursing, Midwifery and Social Work, The University of Manchester, Oxford Road, Manchester, UK. gretl.mchugh@manchester.ac.uk
authors.forename: Gretl A
authors.initials: GA
authors.lastname: McHugh
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Silman
authors.forename: Karen A
authors.initials: KA
authors.lastname: Luker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D011787:Quality of Health Care; D013997:Time Factors; D006113:United Kingdom; D014850:Waiting Lists