Improving osteoarthritis diagnosis and management in the primary care setting: a concise educational tool for primary care providers.

backgroundOsteoarthritis (OA) is the most common form of arthritis, and its prevalence is increasing. We developed an educational tool to improve primary care provider (PCP) comfort with diagnosis and management of non-inflammatory arthritis.

methodsA pilot survey of PCP comfort with OA informed the creation of a two-page educational tool which was introduced at 28 clinics within the University of Vermont Health Network. The tool's utility was assessed with pre- (n = 94) and post-intervention (n = 32) surveys. We conducted a chart review of adult patients diagnosed with OA at new patient rheumatology visits between 2020 and 2022.

resultsOA was the principal diagnosis at 9% of new patient rheumatology visits. Among 390 patients diagnosed with OA, 22 (5%) returned to rheumatology clinic within 6 months. Patients traveled on average 31 miles (SD ± 30) and 40 min (SD ± 31) one-way to reach new patient appointments. Pre-intervention, clinicians were least comfortable knowing when to refer to rheumatology and most comfortable diagnosing OA. Post-intervention, there were improvements in total comfort with OA management and when to refer to orthopedics. Half of clinicians (50%) used the tool in practice, 63% in medical education and 43% in shared decision making. Post-intervention, 34% expected a reduction in rheumatology referrals and 9% reported placing fewer referrals already.

conclusionsA small percentage of patients with OA require ongoing rheumatologic care, with patients traveling a significant distance for evaluation. The introduction of a concise educational tool for PCPs improved comfort managing non-inflammatory arthritis with anticipation of fewer referrals to rheumatology.