Patient priorities in osteoarthritis and co-morbid conditions: a secondary analysis of qualitative data

Cheraghi-Sohi, Sudeh, Bower, Peter, Kennedy, Anne, Morden, Andrew, Rogers, Anne, Richardson, Jane, Sanders, Tom, Stevenson, Fiona and Ong, Bie Nio (2012) Patient priorities in osteoarthritis and co-morbid conditions: a secondary analysis of qualitative data. Arthritis & Rheumatism. (doi:10.1002/acr.21897). (PMID:23203840)

Abstract

Objectives

A lack of agreement between clinician and patient priorities can impact on the clinician-patient relationship, treatment concordance and potentially health outcomes. Studies have suggested that patients with OA may prioritise co-morbidities over their OA, but as yet no explicit systematic exploration of OA patients' priorities in relation to co-morbidities exists. This paper aims to explore how patients prioritise OA amongst their conditions, what factors underlie this prioritisation and whether and why these priorities change over time.

Methods

A secondary analysis of qualitative data was conducted utilising 4 existing datasets collated from the 3 research centres involved. Purposive sampling provided a sample of 30 participants who all had OA and co-morbidities. The research team collectively coded and analysed the data thematically.

Results

Three groups of patient emerged from the analysis. The two smaller groups had stable priorities (where OA was or was not prioritised) and illustrated the importance of factors such as personal social context and the specific nature of the co-morbid conditions. The third and largest group reported priorities that shifted over time. Shifting appeared to be influenced by participants' perceptions of control and/or interactions with clinical professionals, and could have important consequences for self-management behaviour.

Conclusions

The various factors underlying patients' priorities amongst their conditions and the fluctuating nature of these priorities highlights the importance of regular assessments during clinician-patient consultations to allow better communication and treatment planning and ultimately optimise patient outcomes.

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Contributors

Author: Anne Kennedy

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