Management of Osteoarthritis of the Knee by Primary Care Physicians

Lorrie A. Mamlin, Catherine A. Melfi, Michael L. Parchman, Benjamin Gutierrez, Deborah Allen, Barry Katz, Robert S. Dittus, David A. Heck, Deborah A. Freund

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Background: Most patients with osteoarthritis (OA) are treated by primary care physicians (in this article, primary care physicians are family physicians and general internists). Objective: To describe and compare the self-reported practice patterns of family physicians and general internists for the evaluation and management of severe OA of the knee, including factors that might influence referral for total knee replacement. Design, Setting, and Participants: A survey was developed and mailed to randomly selected community family physicians and general internists practicing in Indiana. Main Outcome Measure: Self-reported physician practice patterns regarding OA of the knee. Results: Physical examination was the most common method of evaluating OA of the knee. Family physicians were more likely to examine for crepitation, joint stability, and quadriceps muscle strength than were general internists (P<.05). Patients with OA of the knee treated by family physicians were more likely to receive nonsteroidal anti-inflammatory drugs or oral corticosteroids and were less likely to receive aspirin, acetaminophen, or narcotics compared with patients treated by general internists. Six patient characteristics were rated as positive factors favoring a referral for possible total knee replacement, 8 characteristics were rated as negative, and 5 were rated as not a factor in the decision about referral. Conclusions: Results from this study suggest that additional research is needed to determine the evaluative techniques for OA of the knee that provide the most useful information for management decisions, the management techniques that maximize patient outcomes, and the criteria that should be used to select patients who would benefit most from referral for possible total knee replacement.

Original languageEnglish
Pages (from-to)563-567
Number of pages5
JournalArchives of Family Medicine
Volume7
Issue number6
StatePublished - Nov 1998

Fingerprint

Knee Osteoarthritis
Primary Care Physicians
Family Physicians
Knee Replacement Arthroplasties
Referral and Consultation
Physicians' Practice Patterns
Information Management
Narcotics
Quadriceps Muscle
Muscle Strength
Acetaminophen
Osteoarthritis
Aspirin
Physical Examination
Adrenal Cortex Hormones
Anti-Inflammatory Agents
Joints
Outcome Assessment (Health Care)
Research
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mamlin, L. A., Melfi, C. A., Parchman, M. L., Gutierrez, B., Allen, D., Katz, B., ... Freund, D. A. (1998). Management of Osteoarthritis of the Knee by Primary Care Physicians. Archives of Family Medicine, 7(6), 563-567.

Management of Osteoarthritis of the Knee by Primary Care Physicians. / Mamlin, Lorrie A.; Melfi, Catherine A.; Parchman, Michael L.; Gutierrez, Benjamin; Allen, Deborah; Katz, Barry; Dittus, Robert S.; Heck, David A.; Freund, Deborah A.

In: Archives of Family Medicine, Vol. 7, No. 6, 11.1998, p. 563-567.

Research output: Contribution to journalArticle

Mamlin, LA, Melfi, CA, Parchman, ML, Gutierrez, B, Allen, D, Katz, B, Dittus, RS, Heck, DA & Freund, DA 1998, 'Management of Osteoarthritis of the Knee by Primary Care Physicians', Archives of Family Medicine, vol. 7, no. 6, pp. 563-567.
Mamlin LA, Melfi CA, Parchman ML, Gutierrez B, Allen D, Katz B et al. Management of Osteoarthritis of the Knee by Primary Care Physicians. Archives of Family Medicine. 1998 Nov;7(6):563-567.
Mamlin, Lorrie A. ; Melfi, Catherine A. ; Parchman, Michael L. ; Gutierrez, Benjamin ; Allen, Deborah ; Katz, Barry ; Dittus, Robert S. ; Heck, David A. ; Freund, Deborah A. / Management of Osteoarthritis of the Knee by Primary Care Physicians. In: Archives of Family Medicine. 1998 ; Vol. 7, No. 6. pp. 563-567.
@article{1a938794b75b4f0297d5c64d9cf77b81,
title = "Management of Osteoarthritis of the Knee by Primary Care Physicians",
abstract = "Background: Most patients with osteoarthritis (OA) are treated by primary care physicians (in this article, primary care physicians are family physicians and general internists). Objective: To describe and compare the self-reported practice patterns of family physicians and general internists for the evaluation and management of severe OA of the knee, including factors that might influence referral for total knee replacement. Design, Setting, and Participants: A survey was developed and mailed to randomly selected community family physicians and general internists practicing in Indiana. Main Outcome Measure: Self-reported physician practice patterns regarding OA of the knee. Results: Physical examination was the most common method of evaluating OA of the knee. Family physicians were more likely to examine for crepitation, joint stability, and quadriceps muscle strength than were general internists (P<.05). Patients with OA of the knee treated by family physicians were more likely to receive nonsteroidal anti-inflammatory drugs or oral corticosteroids and were less likely to receive aspirin, acetaminophen, or narcotics compared with patients treated by general internists. Six patient characteristics were rated as positive factors favoring a referral for possible total knee replacement, 8 characteristics were rated as negative, and 5 were rated as not a factor in the decision about referral. Conclusions: Results from this study suggest that additional research is needed to determine the evaluative techniques for OA of the knee that provide the most useful information for management decisions, the management techniques that maximize patient outcomes, and the criteria that should be used to select patients who would benefit most from referral for possible total knee replacement.",
author = "Mamlin, {Lorrie A.} and Melfi, {Catherine A.} and Parchman, {Michael L.} and Benjamin Gutierrez and Deborah Allen and Barry Katz and Dittus, {Robert S.} and Heck, {David A.} and Freund, {Deborah A.}",
year = "1998",
month = "11",
language = "English",
volume = "7",
pages = "563--567",
journal = "Archives of Family Medicine",
issn = "1063-3987",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Management of Osteoarthritis of the Knee by Primary Care Physicians

AU - Mamlin, Lorrie A.

AU - Melfi, Catherine A.

AU - Parchman, Michael L.

AU - Gutierrez, Benjamin

AU - Allen, Deborah

AU - Katz, Barry

AU - Dittus, Robert S.

AU - Heck, David A.

AU - Freund, Deborah A.

PY - 1998/11

Y1 - 1998/11

N2 - Background: Most patients with osteoarthritis (OA) are treated by primary care physicians (in this article, primary care physicians are family physicians and general internists). Objective: To describe and compare the self-reported practice patterns of family physicians and general internists for the evaluation and management of severe OA of the knee, including factors that might influence referral for total knee replacement. Design, Setting, and Participants: A survey was developed and mailed to randomly selected community family physicians and general internists practicing in Indiana. Main Outcome Measure: Self-reported physician practice patterns regarding OA of the knee. Results: Physical examination was the most common method of evaluating OA of the knee. Family physicians were more likely to examine for crepitation, joint stability, and quadriceps muscle strength than were general internists (P<.05). Patients with OA of the knee treated by family physicians were more likely to receive nonsteroidal anti-inflammatory drugs or oral corticosteroids and were less likely to receive aspirin, acetaminophen, or narcotics compared with patients treated by general internists. Six patient characteristics were rated as positive factors favoring a referral for possible total knee replacement, 8 characteristics were rated as negative, and 5 were rated as not a factor in the decision about referral. Conclusions: Results from this study suggest that additional research is needed to determine the evaluative techniques for OA of the knee that provide the most useful information for management decisions, the management techniques that maximize patient outcomes, and the criteria that should be used to select patients who would benefit most from referral for possible total knee replacement.

AB - Background: Most patients with osteoarthritis (OA) are treated by primary care physicians (in this article, primary care physicians are family physicians and general internists). Objective: To describe and compare the self-reported practice patterns of family physicians and general internists for the evaluation and management of severe OA of the knee, including factors that might influence referral for total knee replacement. Design, Setting, and Participants: A survey was developed and mailed to randomly selected community family physicians and general internists practicing in Indiana. Main Outcome Measure: Self-reported physician practice patterns regarding OA of the knee. Results: Physical examination was the most common method of evaluating OA of the knee. Family physicians were more likely to examine for crepitation, joint stability, and quadriceps muscle strength than were general internists (P<.05). Patients with OA of the knee treated by family physicians were more likely to receive nonsteroidal anti-inflammatory drugs or oral corticosteroids and were less likely to receive aspirin, acetaminophen, or narcotics compared with patients treated by general internists. Six patient characteristics were rated as positive factors favoring a referral for possible total knee replacement, 8 characteristics were rated as negative, and 5 were rated as not a factor in the decision about referral. Conclusions: Results from this study suggest that additional research is needed to determine the evaluative techniques for OA of the knee that provide the most useful information for management decisions, the management techniques that maximize patient outcomes, and the criteria that should be used to select patients who would benefit most from referral for possible total knee replacement.

UR - http://www.scopus.com/inward/record.url?scp=0032215366&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032215366&partnerID=8YFLogxK

M3 - Article

VL - 7

SP - 563

EP - 567

JO - Archives of Family Medicine

JF - Archives of Family Medicine

SN - 1063-3987

IS - 6

ER -