PhD defence I.G.(Ilgin) Arslan

Dissertation in short:

Osteoarthritis (OA) in the knee or hip is a highly prevalent chronic disease in the general population. The prevalence and associated healthcare demand are expected to increase dramatically in the future. General practitioners (GPs) are often the first point of contact for patients in the Dutch healthcare system and therefore play an important role in the initial recognition and treatment of knee and hip OA. Current evidence on the extent of knee and hip OA in general practice is insufficient, since incidence and prevalence estimates and predictions are based exclusively on codified data from primary-care electronic health records (EHRs), while earlier research showed significant under-recording of OA in codified data from primary-care EHRs. Also, treatment in general practice is suboptimal: overuse of non-recommended care (e.g. inappropriately early referrals from primary to secondary care and X-ray imaging for the diagnosis of OA) and underuse of non-surgical core treatments (e.g. exercise therapy) for knee and hip OA are common. This will all put even more pressure on the sustainability of the healthcare system. To fill these gaps, this thesis aimed to provide more valid knowledge about the incidence and prevalence and about the provision of healthcare related to knee and hip OA in general practice. It also aimed to identify possibilities for improvements to the care, with a focus on Dutch general practice.