Knee and hip osteoarthritis in general practice: Incidence, prevalence and efforts to optimize care

Research output: Types of ThesisDoctoral ThesisInternal

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Osteoarthritis (OA) in the knee or hip is a highly prevalent chronic musculoskeletal disease in the general population. The prevalence and associated healthcare demand are expected to increase dramatically in the future, putting pressure on the healthcare system. General practitioners (GPs) are often the first point of contact for patients in the Dutch healthcare system and therefore play an important role in the initial recognition and treatment of knee and hip OA. Current evidence on the extent of knee and hip OA in general practice is insufficient, since incidence and prevalence estimates and predictions are based exclusively on codified data from primary-care electronic health records (EHRs), while earlier research showed significant under-recording of OA in codified data from primary-care EHRs. Also, treatment in general practice is suboptimal: overuse of non-recommended care (e.g. inappropriately early referrals from primary to secondary care and X-ray imaging for the diagnosis of OA) and underuse of non-surgical core treatments (e.g. exercise therapy) for knee and hip OA are common. The insufficient knowledge about the extent of knee and hip OA and suboptimal treatment in general practice for knee and hip OA lead to inadequate planning and prioritization of healthcare resources, low quality of care, redundant healthcare consumption, high healthcare costs, poor healthcare outcomes and low patient and healthcare provider satisfaction. This will all put even more pressure on the sustainability of the healthcare system. To fill these gaps, this thesis aimed to provide more valid knowledge about the incidence and prevalence and about the provision of healthcare related to knee and hip OA in general practice. It also aimed to identify possibilities for improvements to the care, with a focus on Dutch general practice.
Original languageEnglish
  • Zeinstra, Sita, Supervisor
  • Bindels, Patrick, Supervisor
  • Schiphof, Dieuwke, Co-supervisor
Award date1 Nov 2022
Place of PublicationRotterdam
Print ISBNs978-94-92332-47-9
Publication statusPublished - 1 Nov 2022


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