En mixed-metod analys av de kulturella, sociodemografiska och ekonomiska elementen som påverka artros behandlingsresultaten

Projekt: Avhandling



The intervention outcome of generic treatment depends not only on the specific effect of the treatment itself but also on the result of a complex interaction between several effects such as the natural history of the disease (Jewell, 2016), the contextual effect (Testa & Rossettini, 2016), the regression to the mean effect (Linden, 2013) and the Hawthorne effect (Goodwin et al., 2017). In particular, the context into which the treatment is delivered, seems to influence the results of an intervention by modulating the pain experience, moreover if persistent (Rossettini, Carlino & Testa, 2018). This context entails cultural (e.g., clinical practice guidelines knowledge, sociodemographic and economic influencers (e.g., levels of education, employment etc.) . In OA, international clinical practice guidelines recommend exercise and education as first-line intervention. However, less than one-third of people with this disease is receiving the proper care. Clinicians often perceive themselves as under-prepared and unfamiliar with clinical practice guidelines. Moreover, these interventions are part of the patients’ self-management for life and require patients to reach a high level of compliance towards them. Thus, patients have a crucial role in determining their health outcomes. Hence, this PhD project aims at analysing some of the patients’ and clinicians’ cultural, sociodemographic and economic elements that can impact on the adherence to first-line interventions.

Populärvetenskaplig beskrivning

In a world where clinical decision-making is based on evidence-based medicine, there is no room for uncertainty in the treatment of our patients. However, did you know that less than 40% of people with this disease receive evidence-based intervention? This poor quality of care might stem from several reasons, which is why a project that investigates why patients with osteoarthritis are not receiving the proper care is necessary.

Firstly, the lack of knowledge of the clinicians of the clinical practice guidelines, as well as their and patients’ beliefs about the pathology may be one of the first reasons behind the low quality of care for patients with osteoarthritis. So the first aim of my project is to analyse the level of physiotherapists’ knowledge and adherence of osteoarthritis clinical practice guidelines and patients’ beliefs about the management of osteoarthritis.

Secondly, sociodemographic factors seemed to influence disease status and care response. People in lower socioeconomic positions show a higher incidence of osteoarthritis, more severe symptomatology and tend to experience less benefit from osteoarthritis intervention. Investigating the relationship between socioeconomic classes and osteoarthritis intervention outcome is therefore necessary.

Investigating the factors mentioned earlier will pave the way for new ways to treat patients, enhancing patients’ quality of life.
Gällande start-/slutdatum2019/10/012022/03/01