Background & Aims
Understanding the factors that influence physiotherapists’ clinical decision-making processes is essential for improving the delivery of evidence-based care for knee osteoarthritis(OA). While previous research has explored various aspects of physiotherapy practice in musculoskeletal conditions, limited attention has been given to the specific factors influencing adherence to evidence-recommended interventions in the management of knee OA, particularly in the context of diverse healthcare settings such as those found across India. This study aimed to explore the factors that influence physiotherapists’ adherence to evidence-recommended interventions in the management of knee osteoarthritis.
Methods
Using a qualitative descriptive design, we conducted semi structured interviews with 15 physiotherapists across India. Participants were selected using purposive sampling to ensure diversity in experience and setting. Initially, interviews were conducted with 10 physiotherapists, aiming to capture a diverse range of experiences and perspectives. After these initial transcripts were analyzed, 5 additional interviews were carried out. Data saturation was considered achieved when no new themes emerged from these subsequent interviews. The data were analyzed through inductive thematic analysis to identify themes related to clinical decision-making in knee OA management. Using the open coding technique, both researchers assigned codes to each meaningful segment of text. These codes were then systematically compared and categorized to form a list of specific themes, in accordance with the first five steps of Braun & Clarke’s thematic analysis method. These specific themes were then grouped.
Results
Three main themes influencing physiotherapists’ adherence to evidence-based care: biomechanical bias in decision-making, the influence of patient perceptions and preferences, and systemic challenges specific to healthcare settings were identified. A significant biomechanical bias led to an emphasis on prioritizing joint protection strategies in their decision-making processes for managing OA knee. Patient perceptions and demands, often influenced by trust in medical professionals over physiotherapists, pose significant challenges in aligning treatment with evidence-based practices. Systemic issues, including workload and infrastructural limitations, further complicate the delivery of effective OA care.
Conclusions
This study illustrates the multifaceted barriers to implementing evidence-based interventions for knee OA among physiotherapists. Addressing these challenges through systemic reforms, focused educational initiatives, and improved interdisciplinary collaboration is critical for advancing evidence-based, patient-centered OA knee management.
References
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Presenting Author
Hemali Patel
Poster Authors
Topics
- Evidence, Clinical Trials, Systematic Review, Guidelines, and Implementation Science