{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:21:04Z","timestamp":1781083264308,"version":"3.54.1"},"reference-count":79,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,9,11]]},"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Some patients spend years with painful osteoarthritis without consulting for it, including times when they are experiencing persistent severe pain and disability. Beliefs about osteoarthritis and what primary care has to offer may influence the decision to consult but their relative importance has seldom been quantified. We sought to investigate the relative importance of perceived service-related and clinical need attributes in the decision to consult a primary care physician for painful osteoarthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Partial-profile choice-based conjoint analysis study, using a self-complete questionnaire containing 10 choice tasks, each presenting two scenarios based on a combination of three out of six selected attributes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>General population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults aged 50\u2005years and over with hip, knee or hand pain registered with four UK general practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Relative importance of pain characteristics, level of disruption to everyday life, extent of comorbidity, assessment, management, perceived general practitioner (GP) attitude.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>863 (74%) people responded (55% female; mean age 70\u2005years, range: 58\u201393). The most important determinants of the patient's decision to consult the GP for joint pain were the extent to which pain disrupted everyday life (\u2018most\u2019 vs \u2018none\u2019: relative importance 31%) and perceived GP attitude (\u2018legitimate problem, requires treatment\u2019 vs \u2018part of the normal ageing process that one just has to accept\u2019: 24%). Thoroughness of assessment (14%), management options offered (13%), comorbidity (13%) and pain characteristics (5%) were less strongly associated with the decision to consult.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Anticipating that the GP will regard joint pain as \u2018part of the normal ageing process that one just has to accept\u2019 is a strong disincentive to seeking help, potentially outweighing other aspects of quality of care. Alongside the recognition and management of disrupted function, an important goal of each primary care consultation for osteoarthritis should be to avoid imparting or reinforcing this perception.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009625","type":"journal-article","created":{"date-parts":[[2015,10,26]],"date-time":"2015-10-26T22:14:03Z","timestamp":1445897643000},"page":"e009625","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["The relative importance of perceived doctor\u2019s attitude on the decision to consult for symptomatic osteoarthritis: a choice-based conjoint analysis study"],"prefix":"10.1136","volume":"5","author":[{"given":"Domenica","family":"Coxon","sequence":"first","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK"},{"name":"Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Frisher","sequence":"additional","affiliation":[{"name":"The School of Pharmacy, Keele University, Keele, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Jinks","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin","family":"Jordan","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Paskins","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Peat","sequence":"additional","affiliation":[{"name":"Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,10,26]]},"reference":[{"key":"2025121402403338000_5.10.e009625.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61729-2"},{"key":"2025121402403338000_5.10.e009625.2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204763"},{"key":"2025121402403338000_5.10.e009625.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.07.015"},{"key":"2025121402403338000_5.10.e009625.4","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.semarthrit.2013.07.003","article-title":"Health economics in the field of osteoarthritis: an expert's consensus paper from the European Society for Clinical and Economic aspects of Osteoporosis and Osteoarthritis (ESCEO)","volume":"43","author":"Hiligsmann","year":"2013","journal-title":"Semin Arthritis Rheum"},{"key":"2025121402403338000_5.10.e009625.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.12.022"},{"key":"2025121402403338000_5.10.e009625.6","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205393"},{"key":"2025121402403338000_5.10.e009625.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60355-4"},{"key":"2025121402403338000_5.10.e009625.8","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keg438"},{"key":"2025121402403338000_5.10.e009625.9","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-10-153"},{"key":"2025121402403338000_5.10.e009625.10","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.joca.2014.02.006","article-title":"Osteoarthritis and the rule of halves","volume":"22","author":"Sheikh","year":"2014","journal-title":"Osteoarthritis Cartilage"},{"key":"2025121402403338000_5.10.e009625.11","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu409"},{"key":"2025121402403338000_5.10.e009625.12","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmm036"},{"key":"2025121402403338000_5.10.e009625.13","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-8-59"},{"key":"2025121402403338000_5.10.e009625.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2010.01.013"},{"key":"2025121402403338000_5.10.e009625.15","unstructured":"National Institute for Health and Care Excellence. 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