Promoting Best Practice in General Practitioner Management of Osteoarthritis of the Hip and Knee: Arthritis and Musculoskeletal Quality Improvement (AMQuIP) Program

Abstract

This paper reports on the outcomes of a pilot study to optimise general practitioner (GP) management of patients with osteoarthritis (OA) of the hip and knee by identifying gaps between their current practice and best practice. The Breakthrough Series collaborative methodology with several Plan-Do-Study-Act (PDSA) cycles was employed. Participants comprised two Victorian Divisions of General Practice (one rural, one metropolitan), 12 general practitioners/practices (GPs/practices), 10 patients per GP/practice. GPs/practices attended an orientation and three learning workshops and a videoconference. GPs/practices completed PDSA cycles between workshops and reported results at the workshops. GPs/practices reported use of guidelines, change in patient management and change in practice management/systems. All recruited patients completed the SF-12v2 Health survey and WOMAC Osteoarthritis Index questionnaire twice; nine patients participated in face-to-face interviews twice. Follow-up activities including focus groups and face-to-face interviews were held six months after the final workshop. All GPs/practices used the guidelines/key messages, introduced "new" management strategies to patients, and made positive changes to their practice management/systems. Patients reported positive changes and outcomes. There was little difference between rural and metropolitan results. By using a structured methodology and evidence-based guidelines/key messages, GPs can introduce new patient management strategies, and by identifying gaps in practice management/systems, positive change can be achieved.