Osteoarthritis (OA) is the most common chronic disease affecting older adults with the prevalence ranging from 50-80% of the elderly population. Although no cure exists for this condition, therapies that effectively reduce the morbidity do exist. Therefore, the quality of care may impact the patient's outcome. Quality of care can be defined in terms of structures, processes and outcomes. Process of care describes what health care providers do for patients and includes taking a health history, performing a physical examination, ordering diagnostic tests, prescribing medications and performing procedures. This project proposes an intervention to improve the process and hence quality of osteoarthritis care. We plan to develop written, interactive educational material for patients that will promote the patient's role in optimizing his or her own health care and result in improved process of care. This fact sheet will describe the importance of OA and the processes of care that can improve its outcome. it will also prompt patients to evaluate the quality of both their care and of their physician. The fact sheet will be designed to increase the patient's perception of the importance of the care processes of OA for achieving optimal health, increase the patient's role in the getting the care processes performed, and increase the importance of receipt of specified care in the patient's overall evaluation of the provider. The fact sheet will be developed using structured focus groups. The effect of the fact sheet on health care quality will be assessed through a randomized controlled trial of subjects recruited from two clinics at one academic medical center. Half of the subjects will receive the fact sheet by mail; half will receive no intervention. Structured chart reviews and interviews will be conducted at baseline and at 6 months to assess the performance of 11 explicit processes of care for osteoarthritis. Performance on the explicit process measures will be compared across the experimental and control groups.
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