title: Discussing prognosis with patients with osteoarthritis: a cross-sectional survey in general practice.
abstract: Osteoarthritis is a leading cause of chronic pain and disability and one of the most common conditions diagnosed and managed in primary care. Despite the evidence that patients would value discussions about the course of osteoarthritis to help them make informed treatment decisions and plan for the future, little is known of GPs' practice of, or views regarding, discussing prognosis with these patients. A cross-sectional postal survey asked 2500 randomly selected UK GPs their views on discussing prognosis with patients with osteoarthritis and potential barriers or facilitators to such discussions. They were also asked if prognostic discussions were part of their current practice and what indicators they considered important in assessing the prognosis associated with osteoarthritis. Of 768 respondents (response rate 30.7 %), the majority felt it necessary to discuss prognosis with osteoarthritis patients (n = 738, 96.1 %), but only two thirds reported that it was part of their routine practice (n = 498, 64.8 %). Most respondents found predicting the course of osteoarthritis (n = 703, 91.8 %) and determining the prognosis of patients difficult (n = 589, 76.7 %). Obesity, level of physical disability and pain severity were considered the most important prognostic indicators in osteoarthritis. Although GPs consider prognostic discussions necessary for patients with osteoarthritis, few prioritise these discussions. Lack of time and perceived difficulties in predicting the disease course and determining prognosis for patients with osteoarthritis may be barriers to engaging in prognostic discussions. Further research is required to identify ways to assist GPs making prognostic predictions for patients with osteoarthritis and facilitate engagement in these discussions.
authors.affiliation: Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK. l.clarson@keele.ac.uk.
authors.forename: L E
authors.initials: LE
authors.lastname: Clarson
authors.affiliation: General Practice & Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
authors.forename: B I
authors.initials: BI
authors.lastname: Nicholl
authors.affiliation: Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK.
authors.forename: A
authors.initials: A
authors.lastname: Bishop
authors.affiliation: Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK.
authors.forename: R
authors.initials: R
authors.lastname: Daniel
authors.affiliation: Research Institute for Primary Care & Health Sciences, Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, ST5 5BG, UK.
authors.forename: C D
authors.initials: CD
authors.lastname: Mallen
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000379:methods; D005260:Female; D058006:General Practice / Q000379:methods*; D058005:General Practitioners; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000175:diagnosis* / Q000523:psychology; D010817:Physician-Patient Relations; D011379:Prognosis; D012306:Risk; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D006113:United Kingdom
keywords: Osteoarthritis; Primary care; Prognosis