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Osteoarthritis of the knee clinical care standard indicators: 6d-Proportion of patients with knee osteoarthritis with a functional limitation who have a 10% or greater improvement in function 12 months after initiation or change of treatment

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 6d-Proportion of patients with knee osteoarthritis with a functional limitation who have a 10% or greater improvement in function 12 months after initiation or change of treatment
METeOR identifier:Help on this term644320
Registration status:Help on this termHealth, Standard 02/08/2017
Description:Help on this term

Proportion of patients with knee osteoarthritis with a functional limitation who have a 10% or greater improvement in function 12 months after initiation or change of pharmacological and/or non-pharmacological treatment.

Rationale:Help on this term

Knee osteoarthritis “bears more responsibility than any other disease for disability in walking, stair climbing and housekeeping.” (Fransen et al. 2015)

Indicator set:Help on this termClinical care standard indicators: osteoarthritis of the knee Health, Standard 02/08/2017

Collection and usage attributes

Population group age from:Help on this term

45 years

Computation description:Help on this term

Both the numerator and denominator include patients with a ‘functional limitation’. A functional limitation is any limitation to a person’s capacity to carry out activities of daily living and to effectively participate in social roles. Limitations may involve work, hobbies or social activities (European Musculoskeletal Conditions Surveillance and Information Network 2008). Functional limitation should be measured using a clinically validated tool. Examples of validated tools include the Timed Up and Go Test and 30-second Chair Test (OARSI 2013). Providers of care to patients with knee osteoarthritis can use local tools, but need to ensure that the same toosl are used with the same patients at different time points to measure change in function.

Both the numerator and denominator also include patients for whom treatment (pharmacological and/or non-pharmacological) was initiated or for whom there was a change in treatment, who were followed up 12 months after the initiation or change in treatment.

The 12-month time period is an approximation, and can mean between 11 and 13 months inclusive.

'Change of pharmacological and/or non-pharmacological treatment' means that the patient's treatment plan was updated with a new plan in the clinical notes on the patient maintained by the practice (paper or electronic). This provides a new measure of the patient's level of function, which is the basis for the comparison with that taken 12 months later.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of patients with knee osteoarthritis with a functional limitation who have a 10% or greater improvement in function when reviewed 12 months following initiation or change in pharmacological and/or non-pharmacological treatment.

Denominator:Help on this term

Number of patients with knee osteoarthritis with a functional limitation who were reviewed 12 months following initiation or change of pharmacological and/or non-pharmacological treatment.

Comments:Help on this term

Note that health services may not necessarily achieve 100% for this indicator, even when providing appropriate treatment, as there may be patients whose function does not improve despite appropriate clinical intervention. For the patients that do not achieve a minimum of a 10% improvement in function 12 months after initiation or change of pharmacological and/or non-pharmacological treatment (i.e. those excluded from the numerator), this indicator should be used to review whether the interventions for these patients were appropriate, and to monitor the health service’s effectiveness in improving patients’ function limited by osteoarthritis of the knee over time.

This indicator has been adapted from the Health care quality indicators for osteoarthritis (European Musculoskeletal Conditions Surveillance and Information Network 2008).

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termService event
Format:Help on this term

N[NN]

Accountability attributes

Other issues caveats:Help on this term

Applicable setting: all healthcare settings where care is provided to patients with knee osteoarthritis, including primary care, specialist care, hospitals and community settings.

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

Reference documents:Help on this term

European Musculoskeletal Conditions Surveillance and Information Network 2008. Health care quality indicators for osteoarthritis. Truro: European Musculoskeletal Conditions Surveillance and Information Network. Viewed 29 March 2016, http://www.eumusc.net/myUploadData/files/EUMUSC
%20Health%20care%20quality%20indicators%20for%20
OA%20KE.pdf
.

Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M & Bennell KL 2015. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med 49(24): 1554-1557.

OARSI (Osteoarthritis Research Society International) 2013. Physical performance measures. Viewed 9 April 2017, https://www.oarsi.org/research/
physical-performance-measures

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