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  3. 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
Research

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 doi: https://doi.org/10.1136/bmj.b421 (Published 23 February 2009) Cite this as: BMJ 2009;338:b421

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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

Competing interests: No competing interests

02 March 2009
Caroline A Mitchell
GP & Senior Clinical Lecturre
University of Sheffield, S4
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