The Journal of rheumatology vol:41 issue:6 pages:1155-62
Objective: Osteoarthritis (OA) is a common cause of disability worldwide. Knee OA care is often suboptimal. A first necessary step in quality improvement is to gain a clear insight into usual care. The aim of the study was, therefore, to develop a set of evidence-based quality indicators for multidisciplinary high quality knee OA care. Methods: A Rand-modified Delphi Method was used to develop quality indicators for knee OA diagnosis, therapy and follow-up. Recommendations were extracted from international guidelines as well as existing sets of quality indicators and scored by a multidisciplinary expert panel. Based on median score, prioritization and agreement, recommendations were labeled as having a high, uncertain or low potential to measure quality of care and were discussed in a consensus meeting for in- or exclusion. Two final validation rounds yielded a core set of recommendations, which were translated into quality indicators. Results: From a total of 86 recommendations and existing indicators, a core set of 29 recommendations was derived that allowed us to define high quality knee OA care. From this core set, 22 recommendations were considered to be measurable in clinical practice and were transformed into a final set of 21 quality indicators regarding diagnosis, lifestyle/education/devices, therapy and follow-up. Conclusion: Our study provides a robust set of 21 quality indicators for high quality knee OA care, measurable in clinical practice. These process indicators may be used to measure usual care and evaluate quality improvement interventions across the entire spectrum of disciplines involved in knee OA care.