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Impact of a national guideline on use of knee arthroscopy: An interrupted time-series analysis.

ABSTRACT: OBJECTIVE:To assess the impact of the Swedish health authority recommendation against the use of knee arthroscopy in patients aged ?40 years with knee osteoarthritis (OA). DESIGN:Interrupted time series analysis. SETTING:Public health care in Skåne region. PARTICIPANTS:Patients aged ?40 years who underwent knee arthroscopy from January 2010 to December 2015. INTERVENTION(S):National guideline's recommendation against the use of knee arthroscopy in patients with knee OA. MAIN OUTCOME MEASURE(S):1) proportion of patients aged ?40 years with a main diagnosis of Knee OA and/or degenerative meniscal lesions (DML) who underwent knee arthroscopy, and 2) overall knee arthroscopy rate per 100,000 Skåne population aged ?40 years. RESULTS:A total of 6,155 knee arthroscopy were performed among people aged ?40 years during study period. Of 42,044 patients with Knee OA/DML, 3,728 had knee arthroscopy. The recommendation was associated with reductions in the use of knee arthroscopy and two years after the recommendation, there was a reduction of 28.6% (95% CI: 9.3, 47.8) and 34.7% (23.9, 45.4) in proportion of Knee OA/DML patients with knee arthroscopy and the overall knee arthroscopy rate, respectively, relative to that expected if pre-recommendation trend continued. Our sensitivity analysis showed that the use of total knee replacement was stable over the study period. CONCLUSION:The national recommendation was associated with reduction in use of knee arthroscopy in public health care in southern Sweden. However, still 4.5% of these patients underwent knee arthroscopy in 2015 implying that more efforts are required to achieve the recommended target.

SUBMITTER: Kiadaliri A

PROVIDER: S-EPMC7076349 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Impact of a national guideline on use of knee arthroscopy: An interrupted time-series analysis.

Kiadaliri Ali A Bergkvist Dan D Dahlberg Leif E LE Englund Martin M

International journal for quality in health care : journal of the International Society for Quality in Health Care 20191101 9

<h4>Objective</h4>To assess the impact of the Swedish health authority recommendation against the use of knee arthroscopy in patients aged ≥40 years with knee osteoarthritis (OA).<h4>Design</h4>Interrupted time series analysis.<h4>Setting</h4>Public health care in Skåne region.<h4>Participants</h4>Patients aged ≥40 years who underwent knee arthroscopy from January 2010 to December 2015.<h4>Intervention(s)</h4>National guideline's recommendation against the use of knee arthroscopy in patients wit ...[more]

PMID: 31725873

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Dataset Information

Impact of a national guideline on use of knee arthroscopy: An interrupted time-series analysis.

Publications

Impact of a national guideline on use of knee arthroscopy: An interrupted time-series analysis.

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