Quality of Non-Surgical and Non-Pharmacological Knee Osteoarthritis Care in the Maritimes

Abstract

Objectives: To evaluate the quality and types of care individuals with mild-to-moderate knee osteoarthritis receive in the Canadian Maritime provinces, and determine associations with demographic, social, and patient-reported factors.

Methods: Individuals with knee osteoarthritis were invited to complete a healthcare quality survey based on the British Columbia Osteoarthritis (BC OA) survey. The cross-sectional descriptive observational survey assessed four healthcare quality indicators: advice to exercise, advice to lose weight, assessment of ambulatory function, and assessment of non-ambulatory function. Pass-rates were calculated overall and for each quality indicator. Binary logistic regressions determined associations between quality indicators and demographic, social, and patient-reported outcomes. Patient-reported use of exercise and diet as arthritis treatments were added to the quality indicator eligibility criteria as a sensitivity analysis.

Results: Participants (n = 241) had a mean age of 67 (7) years, body mass index of 30.7 (7.5) kg/m² and were 77% female. The overall pass rate was 42.9% using the BC OA criteria, and 49.3% in the sensitivity analysis. Individual quality indicator pass-rates ranged from 4.3% for non-ambulatory function to 85.7% for ambulatory function assessments. The sensitivity analysis increased pass-rates for advice to exercise (61.9%-69.3%) and advice to lose weight (27.9%-35.1%). Pass-rates were not driven by demographic, social, or patient-reported factors.

Conclusions: Over half of individuals with mild-to-moderate knee osteoarthritis did not receive recommended core treatments in the Maritimes, highlighting a need to improve care for this patient group. Quality indicators should be routinely evaluated to determine whether clinical care aligns with best practice guidelines.

Keywords: community survey; exercise; health care quality assessment; healthcare quality indicator; knee osteoarthritis; quality indicator survey.