{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:38Z","timestamp":1787022158445,"version":"build-2736575974"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["NIHR129011"],"award-info":[{"award-number":["NIHR129011"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Osteoarthritis is a leading cause of joint pain and disability. Intra-articular corticosteroid injections (IACs) are often used in primary care once other recommended treatments have failed. Evidence shows that IACs provide short-term relief of osteoarthritis symptoms, yet little is known about patients\u2019 and primary care clinicians\u2019 experiences and beliefs about their use. We explored patients\u2019 and primary care clinicians\u2019 views about IACs, including the benefits, disadvantages, perceived risks of treatment, when they are used, and factors that affect decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted individual interviews with patients and primary care clinicians and used inductive thematic analysis to investigate their views and experiences of intra-articular corticosteroid injections for osteoarthritis (IACs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>We interviewed 38 patients and 19 primary care clinicians. We identified 6 patient themes: variation in access; awareness of IACs; views of risk and trust; effectiveness of IACs; variation in onset and effect duration; and an alternative to undesirable treatments. In the interviews with clinicians, we identified an overarching theme of caution and competence, which included eight subthemes: confidence and (dis)comfort with practical procedures; risk of adverse outcomes; training; uncertainty about evidence and guidelines; technical uncertainties; IACs use on the osteoarthritis pathway; perceived benefits and impacts of IACs; and the possibility of placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients and clinicians valued IACs\u2019 potential to relieve symptoms and improve quality of life. Variability in patients\u2019 access to treatment appears related to clinicians\u2019 confidence in delivering injections and their concerns about the evidence base. Variation in dose frequency and timing reflect clinicians\u2019 uncertainty about current guidance. Despite variation in effectiveness patients preferred IACs to other forms of pain medication and to delay or avoid surgery. IACs were mostly used as an adjunct treatment before surgery was offered. These findings can inform further research into the effectiveness of IACs and improvements in information and guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0311668","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T13:32:34Z","timestamp":1729690354000},"page":"e0311668","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Intra-articular corticosteroid injections for osteoarthritis: A qualitative study of patients\u2019 and clinicians\u2019 experiences"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3185-1599","authenticated-orcid":true,"given":"Andrew J.","family":"Moore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecily K.","family":"Palmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen L.","family":"Barker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Gooberman-Hill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Judge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikki","family":"Wylde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Whitehouse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,10,23]]},"reference":[{"issue":"10159","key":"pone.0311668.ref001","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(18)32279-7","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"392","author":"SL James","year":"2018","journal-title":"The Lancet"},{"issue":"12","key":"pone.0311668.ref002","doi-asserted-by":"crossref","first-page":"e1169","DOI":"10.1097\/j.pain.0000000000002660","article-title":"Qualitative evidence synthesis using meta-ethnography to understand the experience of living with osteoarthritis pain","volume":"163","author":"F Toye","year":"2022","journal-title":"Pain"},{"issue":"9","key":"pone.0311668.ref003","doi-asserted-by":"crossref","first-page":"e030060","DOI":"10.1136\/bmjopen-2019-030060","article-title":"Experience of living with knee osteoarthritis: a systematic review of qualitative studies","volume":"9","author":"JA Wallis","year":"2019","journal-title":"BMJ Open"},{"issue":"9","key":"pone.0311668.ref004","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1007\/s10067-014-2692-1","article-title":"Impact and therapy of osteoarthritis: the Arthritis Care OA Nation 2012 survey","volume":"34","author":"PG Conaghan","year":"2015","journal-title":"Clinical Rheumatology"},{"issue":"11","key":"pone.0311668.ref005","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/j.joca.2019.06.011","article-title":"OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis","volume":"27","author":"RR Bannuru","year":"2019","journal-title":"Osteoarthritis and Cartilage"},{"issue":"3","key":"pone.0311668.ref006","doi-asserted-by":"crossref","first-page":"45","DOI":"10.33590\/emj\/10023791","article-title":"Tackling Unmet Medical Need: How Slow-Release Intra-articular Corticosteroids Could Play a Role in Improving Quality of Life and Reducing Risk in Osteoarthritis","volume":"7","author":"PG Conaghan","year":"2022","journal-title":"European Medical Journal"},{"key":"pone.0311668.ref007","unstructured":"NICE. 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