How do UK physiotherapists address weight loss among individuals with hip osteoarthritis? A mixed‐methods study

Jackie Waterfield - ORCID 0000-0001-9004-7125 https://orcid.org/0000-0001-9004-7125Previously deposited in Keele University repository on 14 Feb 2019 at: http://eprints.keele.ac.uk/5843/Item not available in this repository.Background Weight loss is recommended as a core treatment for individuals with hip osteoarthritis who are overweight or obese. Physiotherapists play an important role in managing patients with hip osteoarthritis, but little is known about how they address weight. We aimed to explore how UK‐based physiotherapists currently address weight loss among individuals with hip OA.Methods We carried out a mixed‐methods study. A cross‐sectional questionnaire was mailed to 3,126 UK‐based musculoskeletal physiotherapists. Self‐reported approaches to addressing weight loss among individuals with hip osteoarthritis were explored using a case vignette and associated clinical management questions. Semi‐structured telephone interviews (n = 21) were completed with a purposeful sample of physiotherapists who returned the questionnaire and provided consent for further contact. Interview data were analysed thematically.Results There was a 53% response rate to the questionnaires (n = 1,646), and 1,148 responders were eligible for analyses (based on having treated an individual with hip OA in the last 6 months). Eight‐five per cent of physiotherapists reported that they would address the vignette patient's weight, usually via advice (70%). Interviews identified that advice often focused on the importance of weight loss, with some physiotherapists offering basic advice on how to achieve weight loss. Multiple factors influenced their approach, including confidence, perceived remit and patient receptiveness.Conclusions UK physiotherapists commonly address weight loss among patients with hip osteoarthritis, by offering advice relating to the importance of weight loss. However, provision of more specific guidance on how to achieve weight loss is variable. With additional training, physiotherapists could play an important role in supporting weight loss among patients with hip OA, thus potentially optimizing treatment outcomes.This study was funded by the Arthritis Research UK Centre in Primary Care grant (grant number: 18139). M.A.H. was funded by the National Institute for Health Research (NIHR) School for Primary Care Research. C.D.M. is funded by an NIHR Research Professorship (NIHR‐RP‐2014‐04‐026, 2014), the National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care West Midlands and the National Institute for Health Research School for Primary Care Research. R.W. was funded by a NIHR Research Methods Fellowship. J.G.Q. is funded by an NIHR Academic Clinical Lectureship in Physiotherapy, awarded as part of CDM's NIHR Research Professorship in General Practice (NIHR‐RP‐2014‐026). K.B. is funded by an Australian National Health and Medical Research Council Fellowship (#1058440). The NIHR Clinical Research Network West Midlands (previously PCRN West Midlands North) and North Staffordshire Primary Care Research Consortium provided funding for physical therapy research facilitators to distribute the survey to physical therapists working within the Central England (North spoke) and North West Primary Care Research Networks. The funders did not influence the study design or the writing of this article. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.https://doi.org/10.1002/msc.138317pubpub