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How do people with knee osteoarthritis perceive and manage flares? A qualitative study

Parry, E., Dikomitis, Lisa, Peat, G., Chew-Graham, C.A. (2022) How do people with knee osteoarthritis perceive and manage flares? A qualitative study. BJGP Open, 6 (2). ISSN 2398-3795. (doi:10.3399/BJGPO.2021.0086) (KAR id:98450)


Background: Acute flares in people with osteoarthritis (OA) are poorly understood. There is uncertainty around the nature of flares, their impact, and how these are managed. Aim: To explore understandings and experiences of flares in people with knee OA, and to describe self-management and help-seeking strategies. Design & setting: Qualitative interview study of people with knee OA in England. Method: Semi-structured interviews were undertaken with 15 people with knee OA. Thematic analysis was applied using constant comparison methods. Results: The following four main themes were identified: experiencing pain; consequences of acute pain; predicting and avoiding acute pain; and response to acute pain. People with OA described minor episodes that were frequent, fleeting, occurred during everyday activity, had minimal impact, and were generally predictable. This contrasted with severe episodes that were infrequent, had greater impact, and were less likely to be predictable. The latter generally led to feelings of low confidence, vulnerability, and of being a burden. The term ‘flare’ was often used to describe the severe events but this was applied inconsistently and some would describe a flare as any increase in pain. Participants used numerous self-management strategies but tended to seek help when these had been exhausted, their symptoms led to emotional distress, disturbed sleep, or pain experience worse than usual. Previous experiences shaped whether people sought help and who they sought help from. Conclusion: Severe episodes of pain are likely to be synonymous with flares. Developing a common language about flares will allow a shared understanding of these events, early identification, and appropriate management.

Item Type: Article
DOI/Identification number: 10.3399/BJGPO.2021.0086
Uncontrolled keywords: Flares, Knee arthritis, Musculoskeletal, Osteoarthritis, Primary health care, Qualitative research, adult, aged, Article, clinical article, comparative study, demographics, disease course, disease duration, disease severity, emotional stress, England, European American, female, help seeking behavior, human, knee osteoarthritis, knee pain, male, middle aged, patient attitude, qualitative analysis, self care, semi structured interview, sleep disorder, thematic analysis, very elderly, vulnerability
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: National Institute for Health Research (
Depositing User: Manfred Gschwandtner
Date Deposited: 30 Nov 2022 17:33 UTC
Last Modified: 04 Mar 2024 19:17 UTC
Resource URI: (The current URI for this page, for reference purposes)

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