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Abstract
Objectives The aim of this study was to investigate general practitioners’ (GPs) attitudes, beliefs and behaviours regarding the use of exercise for patients with chronic knee pain (CKP) attributable to osteoarthritis.
Setting Primary care GPs in the UK.
Participants 5000 GPs, randomly selected from Binley’s database, were mailed a cross-sectional questionnaire survey.
Outcome measures GPs’ attitudes and beliefs were investigated using attitude statements, and reported behaviours were identified using vignette-based questions. GPs were invited to report barriers experienced when initiating exercise with patients with CKP
Results 835 (17%) GPs responded. Overall, GPs were positive about general exercise for CKP. 729 (87%) reported using exercise, of which, 538 (74%) reported that they would use both general and local (lower limb) exercises. However, only 92 (11% of all responding) GPs reported initiating exercise in ways aligning with best-evidence recommendations. 815 (98%) GPs reported barriers in using exercise for patients with CKP, most commonly, insufficient time in consultations (n=419; 51%) and insufficient expertise (n=337; 41%).
Conclusions While GPs’ attitudes and beliefs regarding exercise for CKP were generally positive, initiation of exercise was often poorly aligned with current recommendations, and barriers and uncertainties were reported. GPs’ use of exercise may be improved by addressing the key barriers of time and expertise, by developing a pragmatic approach that supports GPs to initiate individualised exercise, and/or by other professionals taking on this role.
- chronic knee pain
- osteoarthritis
- exercise
- general practitioners
- surveys and questionnaires
- attitude
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Footnotes
Contributors EC, NEF, MP, TR and ER participated in the design of the study, analysis of the results and helped to draft the manuscript. All authors read and approved the final manuscript.
Funding This paper presents independent research funded by the Arthritis Research UK Centre in Primary Care grant (Grant Number 20202). NEF, an NIHR Senior Investigator, is supported through an NIHR Research Professorship (NIHR-RP-011-015). EC was funded by an NIHR Academic Clinical Fellowship and subsequently by the NIHR School for Primary Care Research bridging funds. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Competing interests None declared.
Patient consent Detail has been removed from these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Ethics approval Keele University (UK) Ethical Review Panel.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The data sets analysed during the current study are available from the corresponding author on reasonable request.
Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected theseerrors and the correct publishers have been inserted into the references.