Authors (including presenting author) :
Hugo Pak-Yiu Fong (1)(2), Shirley Yue-Kwan Choi (1), Maria Kwan-Wa Leung (1), Regina Wing-Shan Sit (2)
Affiliation :
(1) Department of Family Medicine, the New Territories East Cluster, Hospital Authority
(2) The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
Introduction :
Exercise therapy is a core treatment recommended by international guidelines for knee osteoarthritis (OA), yet exercise prescription remains underutilized in primary care worldwide. While many overseas qualitative studies have examined factors influencing primary care doctors’ exercise prescription for knee OA, this issue has not been explored in Hong Kong’s primary care setting, which faces unique challenges including short consultation times and heavy patient loads.
Objectives :
This study aims to investigate the facilitators and barriers affecting exercise prescription for knee OA patients by primary care doctors in Hong Kong.
Methodology :
A qualitative study using semi-structured interviews was conducted from April 2024 to November 2024. Purposive sampling was employed to recruit primary care doctors from both the private and public sectors in Hong Kong. The Theoretical Domains Framework guided the development of the interview guide, and thematic analysis was conducted using an inductive approach.
Result & Outcome :
Twenty primary care doctors participated in the study. Participants described significant factors affecting exercise prescription behavior for knee osteoarthritis patients in Hong Kong’s primary care, which were organized into four main themes: (1) Knowledge and Skills of Doctors, (2) Environmental and External Factors, (3) Patient-Related Factors, and (4) Doctors’ Perceived Pros and Cons of Exercise Prescription.
Two subthemes emerged under Knowledge and Skills of Doctors: (i) Insufficient knowledge of exercise prescription and (ii) Varying skills in demonstrating and delivering exercise prescriptions. Environmental and External Factors comprised three subthemes: (i) Time constraints limiting exercise prescription, (ii) Lack of OA exercise prescription guidelines, and (iii) Insufficient clinic resources for effective exercise prescription. Patient-Related Factors included three subthemes: (i) Mismatch between patient expectations and exercise prescription, (ii) Varied patient attitudes towards exercise, and (iii) Influence of patient feedback on doctors’ willingness to prescribe exercise. Lastly, three subthemes emerged under Doctors’ Perceived Pros and Cons of Exercise Prescription: (i) Mixed perceived effectiveness of exercise for knee OA among doctors, (ii) Concerns regarding potential harm from incorrect exercise, and (iii) Limited financial rewards from exercise prescription.
This study provides a comprehensive understanding of the barriers and facilitators influencing exercise prescription for knee OA by primary care doctors in Hong Kong. These findings could inform strategies and further training to primary care doctors to enhance the utilization of exercise prescription for OA knee patients in Hong Kong’s primary care setting.
