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Confusion Surrounding Osteoarthritis in Primary Care

Themes of complexity, dissonance, prioritization identified in video analysis of 19 OA consultations

TUESDAY, Nov. 24, 2015 (HealthDay News) — There is confusion between patients and doctors about osteoarthritis (OA) and its context within multimorbidity, according to a study published in the November/December issue of the Annals of Family Medicine.

Zoe Paskins, M.B.B.S., Ph.D., from Keele University in the United Kingdom, and colleagues conducted an observational study in general practices in the United Kingdom to identify how to improve care for OA. Video-recorded real-life consultations of unselected patients and their general practitioners (GPs) were observed.

In an analysis of 19 OA consultations and matched GP and patient interviews, the researchers identified three key themes: complexity, dissonance, and prioritization. OA often arose in the consultation within complex contexts of multimorbidity and multiple patient agendas, which were often not explicit. Patient-doctor dissonance was frequently reported and observed; this was seen when GPs normalized OA symptoms as part of life, and offered reassurance unnecessarily. GPs frequently used the term “wear and tear” instead of OA, or did not name OA. GPs subconsciously assumed that patients did not prioritize OA and that symptoms raised late in the consultation were not bothersome.

“This study highlights generic communication issues regarding the potential negative consequences of unsought reassurance and the importance of validation of symptoms, and raises new arguments for tackling OA’s identity crisis by developing a clearer medical language with which to explain OA,” the authors write.

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