Skip to main content
SpringerLink
Log in

Evaluation of patients’ and physicians’ expectations and attributes of osteoarthritis treatment using Kano methodology

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To evaluate expectations regarding osteoarthritis (OA) treatment of patients (PT) and physicians (PH) (Orthopedic Surgeons) in Spain.

Methods

Multicenter, cross-sectional study in adult patients with OA with at least 1 year of disease progression and with at least one prescription of anti-inflammatory drugs within the last year. Sociodemographic, clinical, and treatment characteristics as well as patient-reported outcomes were obtained by phone interview. Using a treatment expectations questionnaire and applying Kano methodology, treatment attributes were classified as: must-be; one-directional; attractive; indifferent; reverse or questionable.

Results

A total of 965 adult patients with OA [mean age: 64 years (SD: 11); 75% women] and 383 PH [mean age: 47 years (SD: 10); 14% women] were surveyed. None of the treatment attributes showed a dominant “must-be” characteristic. The attributes that led to a greater dissatisfaction when absent were non-occurrence of long-term adverse effects, no discomfort upon administration, and achievement of symptoms relief. The two attributes that were considered most important by PT were as follows: achievement of both total disappearance of the symptoms and lasting symptom relief. Conversely, for PH, the two most important attributes were related to short- and long-term safety.

Conclusions

A clear different perspective regarding treatment expectation was noted among PT (effectiveness) and PH (safety). Therefore, when selecting the most appropriate treatment for OA, PH should invite PT to participate in the decision making.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

PT:

Patient

PH:

Physician

OA:

Osteoarthritis

NSAIDs:

Non-steroidal anti-inflammatory drugs

COX-2:

Cyclooxygenase-2

PRO:

Patient reported outcomes

EQ-VAS:

EuroQoL group’s visual analog scale

HAQ-DS:

Health Assessment Questionnaire Disability Score (HAQ-DS)

K:

Index of concentration of answers

Q:

Statistical signification of Kano’s classification

CS:

Coefficient of satisfaction

CD:

Coefficient of dissatisfaction

IQR:

Interquartile range

SD:

Standard deviation

KMO:

Kaiser–Meyer–Olkin test

EFA:

Exploratory factor analysis

ML:

Maximum likelihood

References

  1. Felson, D. T., Lawrence, R. C., Dieppe, P. A., et al. (2001). Osteoarthritis: new insights. Part 1: The disease and its risk factors. Annals of Internal Medicine, 133(8), 635–646.

    Google Scholar 

  2. Zhang, Y., & Jordan, J. M. (2008). Epidemiology of osteoarthritis. Rheumatic Disease Clinics of North America, 34(3), 515–529.

    Article  PubMed  Google Scholar 

  3. Felson, D. T., & Zhang, Y. (1998). An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis and Rheumatism, 41(8), 1343–1355.

    Article  PubMed  CAS  Google Scholar 

  4. Lawrence, R. C., Felson, D. T., Helmick, C. G., et al. (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis and Rheumatism, 58(1), 26–35.

    Article  PubMed  Google Scholar 

  5. Loza, E., Lopez-Gomez, J. M., et al. (2009). Economic burden of knee and hip osteoarthritis in Spain. Arthritis and Rheumatism, 61(2), 158–165.

    Article  PubMed  Google Scholar 

  6. Carmona, L., Ballina, J., Gabriel, R., & Laffon, A. (2001). The burden of musculoskeletal diseases in the general population of Spain: Results from a national survey. Annals of Rheumatic Diseases, 60(11), 1040–1045.

    Article  CAS  Google Scholar 

  7. Neville, C., Fortin, P. R., Fitzcharles, M. A., et al. (1999). The needs of patients with arthritis: the patient’s perspective. Arthritis Care and Research, 12(2), 85–95.

    Article  PubMed  CAS  Google Scholar 

  8. Wright, J. G., & Young, N. L. (1997). The patient-specific index: Asking patients what they want. Journal of Bone Joint Surgery American Volume, 79(7), 974–983.

    CAS  Google Scholar 

  9. Lieberman, J. R., Dorey, F., Sbekelle, P., et al. (1996). Differences between patients’ and physicians’ evaluations of outcome after total hip arthroplasty. Journal of Bone and Joint Surgery. American Volume, 78, 835–838.

    CAS  Google Scholar 

  10. Khanna, D., & Tsevat, J. (2007). Health-related quality of life- an introduction. American Journal of Managing Care, 13(9), S123–S128.

    Google Scholar 

  11. Strand, V., & Kelman, A. (2004). Outcome measures in osteoarthritis: Randomized controlled trials. Current Rheumatology Reports, 6(1), 20–30.

    Article  PubMed  Google Scholar 

  12. Guccione, A. A., Felson, D. T., Anderson, J. J., et al. (1994). The effects of specific medical conditions on the functional limitations of elders in the Framingham study. American Journal of Public Health, 84(3), 351–358.

    Article  PubMed  CAS  Google Scholar 

  13. DeFrances, C. J., & Podgornik, M. N. (2006). 2004 National hospital discharge survey. Advanced Data, 371, 1–19.

    Google Scholar 

  14. Kellgren, J., & Lawrence, J. (1963). Atlas of standard radiographs. The epidemiology of chronic rheumatism (Vol. 2). Oxford, UK: Blackwell Scientific Publications.

    Google Scholar 

  15. Picavet, H. S. J., & Hoeymans, N. (2004). Health related quality of life in multiple musculoskeletal diseases: SF-36 and EQ-5D in the DMC3 study. Annals of Rheumatic Diseases, 63, 723–729.

    Article  CAS  Google Scholar 

  16. Rabenda, V., Burlet, N., Ethgen, O., et al. (2005). A naturalistic study of the determinants of health related quality of life improvements in osteoarthritid patients treated with non-specific non-steroidal anti-inflammatory drugs. Annals of Rheumatic Diseases, 64, 688–693.

    Article  CAS  Google Scholar 

  17. Van der Waal, J. M., Terwee, C. B., van der Windt, A. W. M., Bouter, L. M., & Dekker, J. (2005). The impact of non-traumatic hip and knee disorders on health-related quality of life as measured with the SF-36 or SF-12. A Systematic Review Quality of Life Research, 14(4), 1141–1155.

    Article  Google Scholar 

  18. Corbella Jané, A., & Maturana Dominguez, S. (2003). Citizens’ role in health services: Satisfaction behavior: Kano’s model, part 1. Quality Management in Health Care, 12(1), 64–71.

    PubMed  Google Scholar 

  19. Corbella Jané, A., & Maturana Dominguez, S. (2003). Citizens’ role in health services: satisfaction behavior: Kano’s model, part 2. Quality Management in Health Care, 12(1), 72–80.

    PubMed  Google Scholar 

  20. Kano, N., Seraku, N., Takahashi, F., & Tsuji, S. (1984). Attractive quality and must-be quality. Journal of Japanish Society of Quality Control, 14(2), 39–48.

    Google Scholar 

  21. Berger, C., Blauth, R., Boger, D., et al. (1993). Kano’s methods for understanding customer defined quality. Center for Quality of Management, 2(4), 3–36.

    Google Scholar 

  22. Wan-I, L. (2007). The relationship between quality of healthcare service and customer satisfaction- an example of hospital in Taiwan. Journal of the Chinese Institute of Industrial Engineers, 24(1), 81–95.

    Article  Google Scholar 

  23. King, B. (1989). Better designs in half the time: Implementing QFD quality function deployment in America. Methuen, MA: GOAL/QPC.

    Google Scholar 

  24. Nelson, C. E., & Larson, C. (1993). Patient’s good and bad surprises: how do they relate to overall patient satisfaction. Quality Review Bulletin, 82, 543–545.

    Google Scholar 

  25. Berger, C. (1993). Kano’s method for understanding customer-defined quality. Center for Quality of Management Journal, 2(4), 313–327.

    Google Scholar 

Download references

Acknowledgments

The authors have declared no conflicts of interest. The study was supported by a restricted grant from Merck and Co. Inc Spain. Editorial support was provided by Pipeline Biomedical Resources and supported by Merck and Co. Inc, Spain.

Author information

Authors and Affiliations

  1. Hospital Universitario La Princesa, C/Diego de León 62, Océano Antártico 41, Tres Cantos, 28760, Madrid, Spain

    J. Cordero-Ampuero

  2. Hospital Arnau de Villanova, C/San Clemente 12, 46015, Valencia, Spain

    A. Darder

  3. Hospital Verge de la Cinta, C/Esplanetes 14, 43500, Tortosa, Tarragona, Spain

    J. Santillana

  4. Merck Sharp and Dome S.A., C/Josefa Valcárcel 38, 28027, Madrid, Spain

    M. T. Caloto & G. Nocea

Authors
  1. J. Cordero-Ampuero
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Darder
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Santillana
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. T. Caloto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Nocea
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Cordero-Ampuero.

Appendix: questionnaire regarding osteoarthritis treatment expectations

Appendix: questionnaire regarding osteoarthritis treatment expectations

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cordero-Ampuero, J., Darder, A., Santillana, J. et al. Evaluation of patients’ and physicians’ expectations and attributes of osteoarthritis treatment using Kano methodology. Qual Life Res 21, 1391–1404 (2012). https://doi.org/10.1007/s11136-011-0058-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-011-0058-6

Keywords

Search

Navigation