Referral of people with osteoarthritis to self-management programmes: barriers and enablers identified by general practitioners.

Monash Institute of Health Services Research, Monash University, Clayton, Victoria, Australia.
Disability and Rehabilitation (Impact Factor: 1.84). 03/2008; 30(25):1938 - 46. DOI: 10.1080/09638280701774233
Source: PubMed

ABSTRACT We conducted a qualitative descriptive study involving general practitioners (GPs) in Victoria, Australia, to examine the barriers to, and drivers of, referral of patients with osteoarthritis (OA) to self-management programmes.
Participating GPs were asked to respond to a series of open-ended questions regarding their referral of patients with OA to self-management programmes and their perception of the advantages and disadvantages of these programmes for people with OA. Interviews were audio-taped, transcribed verbatim, and analysed to identify primary themes in the data.
Results suggest current referral of OA patients to self-management programmes from within general practice is influenced by GP-related factors, patient-related factors, and programme-related factors. A major barrier to referral was GPs limited knowledge about the availability of local programmes and the types of services these programmes provide to people with OA. Some GPs felt OA is less conducive to self-management interventions compared to other chronic conditions (e.g., diabetes, asthma) and questioned the clinical benefit of programmes for people with OA. Enablers of GP referral included GP knowledge about content and availability of programmes, positive GP attitudes towards patient involvement in these programmes, and patient awareness of the value and availability of these programmes (i.e., patient-mediated referral).
This study suggests multiple barriers and drivers of referral of patients with OA to self-management programmes that could be targeted in the future in order to increase referral to, and uptake of, these programmes in general practice.

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