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RESEARCH: P Ravaud, R-M Flipo, I Boutron, C Roy, A Mahmoudi, B Giraudeau, and T Pham ARTIST (osteoarthritis intervention standardized) study of standardised consultation versus usual care for patients with osteoarthritis of the knee in primary care in France: pragmatic randomised controlled trial BMJ 2009; 338: b421 [Abstract] [Full text]

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A really useful paper

Caroline A Mitchell   (2 March 2009)

A really useful paper 2 March 2009
Caroline A Mitchell, GP & Senior Clinical Lecturre University of Sheffield, S4 Send response to journal: Re: A really useful paper	A pragmatic RCT which evaluates a useful, well described and fairly straightforward 'three step' intervention that all primary care physcicians (specialists or generalists as in the UK) can actually implement in day to day practice. Well done! Your baseline data shows all too clearly the dominance of treatment by NSAIDs, which reflects the dominance of the knee osteoarthritis evidence base by pharanceutical interventions ('medicines based eveidence'). It is a shame that the representativeness of your group may be challenged, as this group represented approximately 10% of potential participants, somewhat limiting generalisability. Motivational interviewing, including goal setting and assessment of the individual patient's willingness to change lies at the heart of this type of intervention. Perhaps professional 'willingness to change' consultation style and process may be positively influenced by the hard work of their peers. Competing interests: None declared