Arthritis care: Comparison of physicians' and patients' views

Objectives: To understand the expressed needs of physicians and their patie nts with respect to arthritis care, identify areas of agreement and disagre ement in doctor and patient views of arthritis care, and to determine the t ypes of educational programs needed. Methods:. Focus group interviews were conducted with 14 physicians of varie d specialties and 12 patients with arthritis from Oxford Health Plans. Inte rviews were audiotaped and transcribed. Analyses were performed by using te xt processing programs from the Unix computer operating system. Common them es were identified and summarized. Results: Physicians and patients agreed that pain and loss of functioning w ere the most important problems patients with arthritis faced and that arth ritis was incurable. Both agreed that doctors need more time to discuss ind ividual concerns with their patients. More information about diet and exerc ise and strategies for reducing social isolation were needed. Doctors and p atients disagreed about the value of nutritional supplements, joint replace ment, and referrals to specialists. Disagreement also existed regarding the belief that pain was an inevitable part of the aging process, and with res pect to the use of drug and surgical therapy. Conclusions: Areas of agreement and disagreement were discussed. Collaborat ion and negotiation were identified as constructive responses to conflicts between physicians and patients. Patients need to be taught self-care strat egies to minimize the impact of arthritis on their daily lives. The specifi c continuing education needs of physicians involved training in exercise, n utrition, occupational and physical therapy, prescriptions, and alternative medicine. Copyright (C) 2000 by W.B. Saunders Company.