title: What influences patients with osteoarthritis to consult their GP about their symptoms? A narrative review.
abstract: BACKGROUND
  Osteoarthritis (OA) is a common cause of disability and consultation with a GP. However research suggests the majority of sufferers choose not to consult their GP regarding their symptoms. Understanding the reasons for consulting is central to optimising patient outcomes. This review aims to summarise existing literature to identify what influences patients with OA to consult their GP.
  
  
  METHODS
  Due to the diversity of both qualitative and quantitative research that has addressed this research question a narrative review of literature has been conducted, backed up by a systematic literature search.
  
  
  RESULTS
  Nineteen papers were identified describing influences on consulting behaviour in patients with likely OA. Health beliefs, such as perceiving OA as an inevitable part of older age about which nothing can be done, in addition to perceiving a negative attitude of the GP, are disincentives to consulting. Severity of pain and disruption of daily activities are important influences towards consultation. Social issues such as the availability of support networks are also likely to be influential. Evidence is lacking about the impact of multi-morbidity on consulting behaviour.
  
  
  CONCLUSIONS
  Pain and disruption of activities appear to push towards consulting and negative attitudes regarding OA (from either the patient or GP) appear to be disincentives to consulting. Findings are limited by estimates of consultation frequency and research involving observation of consultations may improve understanding of these issues. Specifically, further research may address how pain and disrupted function are addressed and if negative attitudes are evident in the consultation.
authors.affiliation: Arthritis Research UK Primary Care Centre, Keele University, Keele ST5 5BG, UK. z.paskins@keele.ac.uk.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Paskins
authors.forename: Tom
authors.initials: T
authors.lastname: Sanders
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Hassell
mesh_terms: D000367:Age Factors; D001294:Attitude to Health; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D009042:Motivation; D010003:Osteoarthritis; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012737:Sex Factors