title: Quality of Community-Based Osteoarthritis Care: A Systematic Review and Meta-Analysis.
abstract: To evaluate the state of quality of care for osteoarthritis (OA) by summarizing studies that have assessed the care provided to patients.
  
  
  
  A systematic review of community-based observational studies of actual clinical practice treating people with OA compared with quality indicators (QIs) was performed. Four databases were searched from January 2000 to November 2015. Two reviewers independently determined study eligibility, assessed risk of bias, and extracted study data. The outcome was adherence to the QIs (pass rate). The overall pass rate (the total number of indicators passed divided by the total number of indicators for which the patients were eligible) was extracted from each study. When at least 50% of the studies had comparable individual QIs, the data were pooled with proportion meta-analyses.
  
  
  
  Fifteen studies comprising 16,103 patients were included, and the median overall pass rate across studies was 41% (range 22-65%). The pooled pass rates for individual QIs were "referral to orthopedic surgeon if no response to other therapy": 59.4% (95% confidence interval [95% CI] 47.5-70.3); "paracetamol or acetaminophen first drug used": 46.0% (95% CI 26.6-66.7); "assessed for pain and/or function": 45.5% (95% CI 33.9-57.6); "referral or recommendation to exercise": 38.7% (28.9-49.5); "offered education and self-management": 35.4% (95% CI 27.8-44.0); and "informed about potential risks if NSAIDs prescribed": 34.1% (95% CI 24.7-44.9).
  
  
  
  There is room for improvement in community-based OA care.
authors.affiliation: National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, and Institute of Health and Society, University of Oslo, Oslo, Norway. k.b.hagen@medisin.uio.no.
authors.forename: Kåre B
authors.initials: KB
authors.lastname: Hagen
authors.affiliation: National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, and Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Smedslund
authors.affiliation: National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Nina
authors.initials: N
authors.lastname: Østerås
authors.affiliation: Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Gro
authors.initials: G
authors.lastname: Jamtvedt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D010003:Osteoarthritis / Q000628:therapy*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*