Abstract :
Knee osteoarthritis (KOA) is one of the common causes of disability. Long-term effects of early to moderate
KOA can be managed through non-surgical interventions. But due to overcrowding in Orthopaedic OPDs,
doctors don’t have enough time for explaining non pharmacological interventions (NPIs) in detail to KOA
patients. Hence, desired impact of NPIs is not evident among KOA patients. This study elaborates the
degree of patient centered approach adopted during doctor patient interactions in the Orthopedics OPD
of a tertiary care hospital of India. The study was conducted in 2012-2015. Eligible KOA patients (N=123)
were divided into two groups for the RCT. The patients aged 40-65 years of either gender without significant
deformity or co-morbidities needing surgery (e.g. meniscus tears etc) were enrolled. An intervention room
was established in Physical and Rehabilitation Medicine (PRM) department of the hospital. Doctors of
Orthopaedics and PRM departments were requested to send grade 1, 2, 3 KOA patients as per Kellgren
Lawrence scale to intervention room after initial work up. A referral system was established for this. Interviews
of the diagnosed patients (N=31) suffering from mild and moderate KOA were conducted. Textual analysis
was done for qualitative data. Patients are unable to comprehend ‘capsule form’ of advice provided in
OPDs. This results in non-adherence. For better outcomes physicians must talk to patients. They need to
understand the patient’s underlying concerns, against their cultural background, and life history. Hence,
patient centred approach is needed for obtaining the desired impact of NPIs in KOA patients reporting to
Orthopaedics OPD in Indian hospitals.
Keyword :
Knee, Osteoarthritis, Non pharmacological interventions, patient centered approach