None listed
Conditions
Brief summary
Every clinical guideline recommends that individuals with knee osteoarthritis (OA) undertake planned, structured, and repetitive physical exercise. Such programs are ideally provided by physiotherapists or exercise physiologists. However, referral for planned exercise programs for people with OA by their GP is low. This prevents many people with knee OA from having the opportunity to participate in a treatment that will improve their knee pain. This study will investigate the effectiveness of two strategies designed to improve access to exercise programs provided by physiotherapists or exercise physiologists. Strategy 1 is including an educational message that exercise is important in the report sent to the GP after the person with knee OA has undergone x-ray. Strategy 2 supplements the GP educational message with an infographic to the person with knee OA informing them about the benefits of exercise for pain and function. We will work with radiology clinics in NSW to compare the strategies with current practice (no information to people with OA or GPs). We expect both strategies will be more effective than current practice in increasing the number of people being referred and attending appointments with physiotherapists or exercise physiologists.
Interventions
(1) A single educational reminder (3 lines of text and a hyperlink to current Royal Australian College of General Pracititoner guidelines for knee OA) included in x-ray report provided to the general practitioner (GP) at point of diagnosis. It is targeted at the GP, however if the person with knee osteoarthritis receives a copy of the report, they will also see the educational reminder message. Educational reminder message has been designed by the research team (consisting of physiotherapists,
(1) A single educational reminder (3 lines of text and a hyperlink to current Royal Australian College of General Pracititoner guidelines for knee OA) included in x-ray report provided to the general practitioner (GP) at point of diagnosis. It is targeted at the GP, however if the person with knee osteoarthritis receives a copy of the report, they will also see the educational reminder message. Educational reminder message has been designed by the research team (consisting of physiotherapists, with more than 15 years experience, and exercise physiologists) in collaboration with general practitioners. It will be included in the reporting template from the radiology clinic performing and reporting on the x-ray. The content of the educational message is: If your patient has structural signs of osteoarthritis, you might refer them to a physiotherapist or an exercise physiologist. Structured land-based exercise programs are effective and safe for all patients with knee OA regardless of comorbidity. (Reference: The Royal Australia College of General Practitioners. Guideline for the management of knee and hip osteoarthritis. 2018). - the citation will be hyperlinked. (2) Educational reminder included in x-ray report and patient-facing infographic delivered to both the general practitioner and patient at point of diagnosis. Educational reminder message is same as above. The infographic is an A4 page taking approximately 1-2 minutes to read. It will be provided, in hard copy, to all people presented to the radiology clinic for a non-traumatic knee x-ray by staff at the radiology clinic. The infographic content has been developed in collaboration with a focus group of consumer advocates - all with knee osteoarthritis. Visual presentation was designed by a graphic designer. Both interventions will be delivered once. To monitor adherence, staff from the radiology clinic will complete a "office use only" section on all participant consent forms. This section includes a tick box to confirm (or otherwise) that the intervention was delivered. There is a question in the follow-up survey for patients to indicate if they received the infographic, this will be cross-referenced to group allocation. Finally, a process evaluation will take place throughout the trial to examine adherence of intervention delivery.
Sponsors
Kathryn Mills
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
45 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(1) Radiology clinics a. currently performing plain musculoskeletal x-rays b. 1 or more radiologist agreeing to be involved; c. current public liability insurance d. able to use reporting templates for knee x-rays. Where radiology franchises operate across several local government areas, the franchise will be approached to determine if each location uses a centralised reporting system and radiologist (e.g. one reporting radiologist across all sites). For practices that use a centralised reporting template/radiologist, only the clinics located in the largest clinic-cluster area will be considered for inclusion. If not, then all radiology clinics belonging to that franchise will be eligible for inclusion. (2) People with knee OA a. aged 45 years or older b. has unilateral or bilateral knee pain of 6 months or longer duration c. has been referred for the x-ray by a GP d. holds a current Medicare card e. is able to read or watch and understand the information and consent form without assistance from another person f. is ambulatory (with or without the assistance of gait aids). g. radiologically confirmed knee OA in any knee compartment h. ability to participate in an email or telephone follow-up
Exclusion criteria
People with knee OA: x-ray referral as a direct result of knee trauma; contraindication to routine knee x-ray; referral for imaging from any medical specialists compensable knee injury; suspected musculoskeletal, cardiovascular or other pathology preventing activity-based interventions (e.g., chronic or terminal lung condition or malignancies); prior knee replacement or awaiting knee replacement
Outcome results
None listed