Patient-reported quality of care for osteoarthritis: development and testing of the osteoarthritis quality indicator questionnaire

Abstract

Objective: To develop and test a new instrument for patient self-reported quality of osteoarthritis (OA) care, and to provide quality indicator (QI) pass rates in a Norwegian OA cohort.

Methods: The OsteoArthritis Quality Indicator (OA-QI) questionnaire was developed using published QIs, expert panels, and patient interviews. Self-reported data were collected from 359 persons in a Norwegian OA cohort, and test-retest reliability and validity were assessed. Separate QI pass rates and summary QI pass rates were calculated.

Results: The 17-item questionnaire includes QIs related to patient education and information, regular provider assessments, referrals, and pharmacologic treatment. The patient self-reported questionnaire was completed with minimal respondent burden. Support for content validity was confirmed by 2 patient research partners and 2 expert panels. All 10 predefined hypotheses relating to construct validity were confirmed. Test-retest kappa coefficients ranged from 0.20-0.80 and the percentage of exact agreement ranged from 62-90%. The mean pass rate for individual QIs was 31% (range 5-49%). The median summary QI pass rate was 27% (interquartile range 12-50%), with lower summary pass rates for nonpharmacologic compared to pharmacologic treatments.

Conclusion: To our knowledge, this is the first instrument developed to measure patient-reported QI pass rates for OA care. This study indicates that the OA-QI questionnaire is acceptable to persons with OA, and its short format makes it suitable for population surveys. The low patient self-reported QI pass rates in this study suggest a potential for quality improvement in OA care.