Pitt and coworkers conducted a qualitative study involving general practitioners (GPs) in Victoria, Australia, to examine the barriers to, and drivers of, referral of patients with osteoarthritis (OA) to self-management programs. Participating GPs were asked to respond to a series of open-ended questions regarding their referral of patients with OA to self-management programs and their perception of the advantages and disadvantages of these programs for people with OA. Interviews were audiotaped, transcribed, and analyzed to identify primary themes in the data. Results suggested current referral of OA patients to self-management programs from is influenced by GP-related factors, patient-related factors, and program-related factors. A major barrier to referral was GPs limited knowledge about the availability of local programs and the types of services they provide to people with OA. Some GPs felt OA is less conducive to self-management interventions compared to other chronic conditions (e.g., diabetes, asthma), and questioned the clinical benefit of programs for people with OA. Enablers of GP referral included GP knowledge about content and availability of programs, positive GP attitudes towards patient involvement in these programs, and patient awareness of the value and availability of the programs (i.e., patient-mediated referral).

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The study suggested multiple barriers and drivers of referral of patients with OA to self-management programs that could be targeted in order to increase referral to, and uptake of, these programs in general practice. The results of the study could likely be similar to health care providers referring patients with other chronic conditions to self-management programs. Many health care providers do not know of available programs or their purpose. If you are initiating a self-management program, it is worthwhile to approach health care providers, much like a drug representative, to explain a program and what can be expected by making referrals.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: As you likely want to learn and perform self-management skills, it is often up to you to prompt your health care provider for a referral to a self-management program. If this approach doesn’t work, you might ask the your provider to have members of his or her staff teach you skills that will help you control your chronic illness.

VJ Pitt et al. Referral of people with osteoarthritis to self-management programmes: Barriers and enablers identified by general practitioners. Disability & Rehabilitation, 2008:19:1-9.