Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study

Objective To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. Methods Study design is a multinational (Australia, New Zealand, Canada) cross‐sectional survey of clinicians (general practitioners [GPs], GP registrars, primar...

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Published in:	ACR open rheumatology Vol. 1; no. 4; pp. 219 - 235
Main Authors:	Briggs, Andrew M., Hinman, Rana S., Darlow, Ben, Bennell, Kim L., Leech, Michelle, Pizzari, Tania, Greig, Alison M., MacKay, Crystal, Bendrups, Andrea, Larmer, Peter J., Francis‐Cracknell, Alison, Houlding, Elizabeth, Desmond, Lucy A., Jordan, Joanne E., Minaee, Novia, Slater, Helen
Format:	Journal Article
Language:	English
Published:	United States John Wiley & Sons, Inc 01-06-2019 John Wiley and Sons Inc
Subjects:	Arthritis Attitudes Back pain Confidence Data collection Exercise Knowledge Likert scale Medical students Nurses Original Physical fitness Primary care Professional development Students Workforce New Zealand Australia Canada
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Summary:	Objective To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. Methods Study design is a multinational (Australia, New Zealand, Canada) cross‐sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final‐year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high‐ and low‐value care (customized items), attitudes toward exercise/physical activity (free‐text responses). Results A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist‐nurse analyses were 9.3 [7.7‐10.9] for knowledge [scale: 11‐55] and 14.6 [12.3‐17.0] for skills [scale: 16‐80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3‐8.4]; scale 10‐60) and in medical students compared with physiotherapy students (2.0 [1.3‐2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%‐19% and 19%‐22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%‐36% and 35%‐44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%‐61% and 21%‐52%). Most agreed (90%‐98% and 92%‐97%) that exercise is indicated and strongly supported by qualitative data. Conclusion Workforce capacity building that de‐emphasizes biomedical management and promotes high‐value first‐line care options is needed. Knowledge and skills among physiotherapists support leadership roles in OA care for this discipline.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Funding for the study was provided by Curtin University, Australia, and the Australian National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translational Research in Musculoskeletal Pain (1079078). Dr. Briggs is supported by a Fellowship awarded by the NHMRC (1132548). Dr. Hinman is supported by NHMRC Fellowship 1154217. Dr. Bennell is supported by NHMRC Fellowship 1058440. E. Houlding was supported by a Mitacs Globalink Research award IT11467. The funding bodies had no role in the design of the study or collection, analysis, and interpretation of data or in writing the manuscript. Andrew M. Briggs, BSc(Phthy)Hons, PhD, FACP, Novia Minaee, BA(Psych), MBiostat, Helen Slater, BAppSci(Phthy), MAppSci(Phthy), PhD, FACP: Curtin University, Perth, Australia; 2Rana S. Hinman, B(Phthy)Hons, PhD, Kim L. Bennell, BAppSci(Phthy), PhD: University of Melbourne, Australia; 3Ben Darlow, B(Phthy), M(Phthy), PhD: University of Otago, New Zealand; 4Michelle Leech, MB BS, PhD, FRACP: Monash University, Australia; 5Tania Pizzari, B(Phthy)Hons, PhD: La Trobe University, Australia; 6Alison M. Greig, BHK, BSc(Phthy)Hons, PhD: University of British Columbia, Canada; 7Crystal MacKay, BSc(Phthy), MHSc, PhD: Toronto Rehabilitation Institute, University Health Network, Canada; 8Andrea Bendrups, MB BS, MSc, FRACP: Royal Melbourne Hospital, University of Melbourne, Australia; 9Peter J. Larmer, Dip(Phthy), Dip(Accup), MPH, DHSc: Auckland University of Technology, New Zealand; 10Alison Francis‐Cracknell, BAppSci(Phthy): Monash University, Australia; 11Elizabeth Houlding Curtin University, Perth, Australia, and University of Ottawa, Ontario, Canada; 12Lucy A. Desmond, BBMed, MD: Western Health, Victoria, Australia; 13 Joanne E. Jordan, BSc, BA, MPH, PhD: HealthSense (Aust) Pty, Ltd, Victoria, Australia. No potential conflicts of interest relevant to this article were reported.
ISSN:	2578-5745 2578-5745
DOI:	10.1002/acr2.1032