Physiotherapi on Osteoarthritis of the knee; an observational study of discharge summaries

Gudmund Grønhaug, prosjektmedarbeider, MSc, fysioterapeututdanningen, Høgskolen i Sør Trøndelag, Trondheim og Baseline fysioterapi. Epost: groenhaug@gmail.com.

Kirsten Marie Grønhaug, Overlege ortopedi St. Olav og Sykehuset Levanger.

Ann Katrin Stensdotter, Phd, fysioterapeututdanningen, Høgskolen i Sør Trøndelag, Trondheim.

Abstract

Background: Knee osteoarthritis (OA) is a common arthritic diagnose, reducing quality of life and functional capacity. Untreated, it may progress to need for total knee replacement. Effective treatment requires communication between different health professionals and across organization levels. Treatment of patients with OA by medical doctors has shown low adherence with recommendations. Whether guidelines for treatment are followed by physiotherapists has not been investigated. 

Purpose: Investigate discharge summaries from physiotherapists to referring physicians and adherence to treatment recommendations.

Method: Patient-records with knee OA were identified (N=83) and letters were sent asking for information about which physiotherapist they had seen for treatment. Letters were sent to the physiotherapists asking for the discharge summary, which they are obliged to send to the referring physician. A survey of the content in the discharge summaries was conducted.

Results: Response rate from patients was 93% (N=81). Of the 81, 13 (15%) had not been referred to physiotherapy treatment. Response rate from physiotherapists was 56% (N=39/68). 61% did not specify the treatment. Others stated strengthening exercises, local muscular endurance, or water exercise; 11 % did not describe any treatment.

Discussion: Effect of treatment was not described and none satisfied criteria and regulations concerning use of discharge summaries. Conclusively, discharge summaries appears not, as required by law, routinely being sent from physiotherapists to referring physician and treatments described are not in line with evidence based international recommendations concerning the treatment of OA of the knee.

Keywords: Arthritis, treatment recommendations, communication, patient records.

Full version in Norwegian.