Patient priorities in osteoarthritis and comorbid conditions: a secondary analysis of qualitative data.

Abstract

OBJECTIVE: A lack of agreement between clinician and patient priorities can impact the clinician-patient relationship, treatment concordance, and potential health outcomes. Studies have suggested that patients with osteoarthritis (OA) may prioritize comorbidities over their OA, but as yet no explicit systematic exploration of OA patients' priorities in relation to comorbidities exists. This study aims to explore how patients prioritize their OA among their conditions, which factors underlie this prioritization, and whether and why these priorities change over time. METHODS: A secondary analysis of qualitative data was conducted utilizing 4 existing data sets collated from the 3 research centers involved. Purposive sampling provided a sample of 30 participants who all had OA and comorbidities. The research team collectively coded and analyzed the data thematically. RESULTS: Three groups of patients emerged from the analysis. The 2 smaller groups had stable priorities (where OA was or was not prioritized) and illustrated the importance of factors, such as personal social context and the specific nature of the comorbid conditions. The third and largest group reported priorities that shifted over time. Shifting appeared to be influenced by the participants' perceptions of control and/or interactions with clinical professionals, and could have important consequences for self-management behavior. CONCLUSION: The various factors underlying patients' priorities among their conditions, and the fluctuating nature of these priorities, highlight the importance of regular assessments during clinician-patient consultations to allow better communication and treatment planning, and ultimately optimize patient outcomes