title: Acceptability of a 'guidebook' for the management of Osteoarthritis: a qualitative study of patient and clinician's perspectives.
abstract: BACKGROUND
  Written information can be of benefit to both practitioners and patients and the provision of quality information is emphasised as a core intervention by United Kingdom National Institute of Clinical Excellence (NICE) OA guidelines. Researchers, patients and HCPs developed an 'OA guidebook' to provide; a) a balanced source of information for patients; b) a resource to aid practitioners when discussing self-management. This study aimed to evaluate the acceptability and usefulness of the OA guidebook as part of complex intervention to deliver NICE OA guidelines in General Practice.
  
  
  METHODS
  The intervention comprises a series of consultations with GPs and practice nurses in which supported self-management is offered to patients. Eight practices in the West Midlands and North West of England were recruited to take part: four control practices and four intervention practices. Semi-structured interviews were undertaken with patients (n = 29), GPs (n = 9) and practice nurses (n = 4) from the intervention practices to explore experiences of the intervention and use of the guidebook. Data were analysed using thematic analysis and constant comparison of data within and across interviews.
  
  
  RESULTS
  GPs thought the guidebook helped provide patients with information about OA aetiology, prognosis and self-management. Thus, it backed up key messages they provided patients during consultations. GPs also found the guidebook helped them 'close off' consultations. Nurses also thought the guidebook helped them describe OA disease processes in consultations. Patients valued the explanations of disease onset, process and prognosis. The use of 'real' people and 'real life' situations contained within the guidebook made self-management strategies seem more tangible. A sense of inclusion and comfort was obtained from knowing other people encountered similar problems and feelings.
  
  
  CONCLUSIONS
  An OA specific written information guidebook was deemed acceptable and useful to practitioners and patients alike as part of the MOSAICS study. Findings reinforce the utility of this model of patient information as a resource to support patients living with chronic illnesses. An OA guidebook featuring a mixture of lay and professional information developed by professionals and lay people is useful and could effectively be used more widely in usual care.
authors.affiliation: Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK. a.morden@keele.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Morden
authors.forename: Clare
authors.initials: C
authors.lastname: Jinks
authors.forename: Bie Nio
authors.initials: BN
authors.lastname: Ong
authors.forename: Mark
authors.initials: M
authors.lastname: Porcheret
authors.forename: Krysia S
authors.initials: KS
authors.lastname: Dziedzic
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000628:therapy*; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards*; D010358:Patient Participation; D017410:Practice Guidelines as Topic / Q000592:standards; D036301:Qualitative Research