In a study published in BMJ Open, Canadian researchers explore the possible barriers that stop patients from starting non-pharmacological approaches when diagnosed with osteoarthritis.

“In a systematic review of studies comparing OA quality indicators to community-based clinical practice, pass rates for first-line non-pharmacological approaches (e.g., exercise, education) were, on average, below 40%,” authors Crystal MacKay PhD, MHSc, BScPT, and colleagues write.

Research has shown that working-age adults with mild-to-moderate osteoarthritis reported limited guidance and support from their healthcare professionals, they note, in a media release from MedPage Today.

“Given the growing awareness of the importance of identifying and initiating treatment in the early phases of OA, it is critical to begin to address this practice gap. Intervening early in the disease has potential to help control OA pain and disability and reduce work loss,” MacKay and colleagues continue.

In addition, the researchers identified enablers of management, including physical therapists’ confidence, beliefs about the consequences of osteoarthritis, and their scope of practice.

“We also identified modifiable factors that can be barriers to management in some situations and can be targeted to improve care: availability and timely access to services in the community (eg, exercise programs) and healthcare systems (eg, physical therapists); healthcare provider factors including time, access to evidence, and physicians’ referrals and messaging to clients; and client engagement in management and beliefs about OA,” the authors write.

Some patients simply believed that nothing could be done about their symptoms, they add.

“Other clients were reluctant to accept an OA diagnosis, particularly when x-rays do not show changes in the early stages of the disease,” they continue.

More studies are needed to find ways to optimize timely access to physical therapists and other programs to increase early interventions, they conclude.

“Addressing these barriers will require a multipronged approach, targeted at both the healthcare system and healthcare providers,” they write.

[Source: MedPage Today]