Joint and soft tissue injections in Irish primary care: a survey of GPs' attitudes and practices

Background: Musculoskeletal conditions are common in primary care, causing significant morbidity. Intra-articular and soft tissue corticosteroid injections are commonly performed by GPs internationally. It is unknown how commonly they are performed by GPs in the Republic of Ireland.Aim: To determine the frequency and type of joint and soft tissue injections performed by GPs in the Republic of Ireland and investigate factors affecting their use.Design & setting: A cross-sectional online questionnaire, which was based on previous international research, was devised for completion by GPs practising in the Republic of Ireland.Method: GPs were invited to electronically complete a questionnaire on their practices and attitudes regarding joint and soft tissue injections.Results: A total of 147 of 204 GPs (72.1%) had performed an intra-articular or soft tissue injection in the preceding year. GPs who were principals or partners, male, or worked in a rural or mixed urban and rural practice setting were more likely to perform these procedures. The most common injection sites were the shoulder and knee. Participants were confident about performing joint and soft tissue injections. It was found that 80.4% had received prior training in this treatment modality, most commonly during their GP training programme. A prolonged wait for secondary care intervention, symptom duration, and symptom severity were factors that increased the likelihood of performing injections. Difficulty maintaining skills and medicolegal concerns were common barriers to performing joint and soft tissue injections.Conclusion: Most GPs surveyed carried out joint and soft tissue injections, most commonly injecting the shoulder and knee. Irish GPs experience many of the same barriers to performing intra-articular injection as experienced internationally.