Who seeks physiotherapy or exercise treatment for hip and knee osteoarthritis? A cross‐sectional analysis of the English Longitudinal Study of Ageing

OBJECTIVES: To determine the characteristics of individuals with hip and/or knee osteoarthritis who are recommended to seek physiotherapy or exercise treatment, and to explore which people are more or less likely to follow such recommendations.
METHODS: All data were obtained from Wave 4 of the English Longitudinal Study of (ELSA) cohort (2008-2009), a prospectively collected community-based dataset. Eligibility was justified by a patient-reported diagnosis of hip and/or knee osteoarthritis with a visual analogue scale (VAS) pain score of one or above. Data were collected from a self-completed questionnaire and nurse assessment visit. Prevalence of being recommended to physiotherapy or exercise (or not) and then the actioning of this recommendation (or not) were calculated and presented as 95% confidence intervals (CI). Data on characteristics of those recommended (or not) were explored using univariate analyses and then a forward selection logistic regression model.
RESULTS: In total, 1262 and 1877 individuals with hip and/or knee osteoarthritis pain were analysed. This included 41% (95% CI: 0.38 to 0.44) who had been recommended to seek physiotherapy or exercise treatment. Subsequently, 83% of those recommended sought these treatments. Individuals who presented with isolated knee pain, those who reported ‘fair’ self-reported general health and were younger had a greater chance of being recommended for physiotherapy or exercise treatment respectively (P≤0.02).
CONCLUSION: Encouragement should be given to formal and informal care providers of older people to highlight this inequality. This may then improve current and future access to evidence-based treatments for this population.

"This is the peer reviewed version of the following article:Smith, T., Collier, T., Smith, B., and Mansfield, M. (2019). Who seeks physiotherapy or exercise treatment for hip and knee osteoarthritis? A cross-sectional analysis of the English Longitudinal Study of Ageing cohort. International Journal of Rheumatic Diseases, which has been published in final form at DOI xxxx This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."

KEYWORDS: Degenerative joint; rehabilitation; exercise therapy; non-surgical; referral patterns; access