Topic: Primary Care Research Network for England, Musculoskeletal
Conditions
Interventions
A Joint Pain/OA Consult Temp: Template developed to record Quality Indicators for OA. To be used as part of routine consultations for patients presenting with a working diagnosis of OA (knee, hip, han
A Model OA Consultation, a three pronged 'Model OA Consultation' has been developed and will be implemented in the four intervention practices.
The model includes consultation with the GP, consultat
Sponsors
Keele University (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: General Practitioners (GP) practices 1. Member of West Midlands North PCRN or a Keele Research Network Practice 2. At least two GPs willing to undertake the study as per protocol i.e. act as a control or intervention practice 3. Willing, and able, to allow one (or for preference two - to allow for cross cover) of their practice nurses to be trained to deliver MOAC 2 and then deliver it in the practice 4. Willing, and able, to allow a PCRN employed nurse trained to deliver MOAC 2 working in their practice 5. Uses the EMIS GO computerised consultation system 6. For the implementation study and evaluation studies additional inclusion criteria are: As above plus 6.1. GP who has received training and has delivered MOAC 1 6.2. Nurse who has received training and has delivered MOAC 2 6.3. Nurse consenting to observation and audio recording of the MOAC 2 consultation 6.4. Members of the multidisciplinary team who have delivered the MOAC 3 intervention 6.5. Practice Manager in intervention practices 6.6. Administrators in intervention practices Patients 1. Males and females 2. 45 years and over 3. Registered with a MOSAICS study practice 4. Consenting to further contact from the study team and medical record review from their response in the Population Survey 5. For the evaluation studies additional criteria are: 5.1. Patients from the intervention practices who have consulted a GP, been given a diagnosis of OA and received the model OA consultation (MOAC) 5.2. To be invited to take part in an individual or group interview participants must have completed the MOSAICS Consultations Questionnaires 5.3. Audio recording and observation of MOAC 2 consultations will only be carried out if a patient has given prior consent to do so Target Gender: Male & Female ; Lower Age Limit 45 years
Exclusion criteria
Exclusion criteria: GP Practices 1. Single handed GP practices 2. Single handed practice nurse 3. Unable to physically accommodate MOAC 2 consultations Patients Excluded via GP screen of practice list. 1. Unable to give fully informed consent e.g. learning difficulties or dementia 2. Resident in a care or nursing home 3. History of serious disease e.g. malignancy, terminal illness 4. Unable to consult in the general practice surgery 6. Inflammatory arthritis (e.g. rheumatoid arthritis, psoriatic arthritis) 7. Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Test the feasibility of using quality indicators for OA as the primary outcome measure; Timepoint(s): At 21 months | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. A trial of paracetamol at up to 4 g/day prior to treatment with oral non steroidal anti-inflammtory drugs (NSAIDs) or opiate analgesics; Timepoint(s): At 15 and 21 months 2. Advice about weight loss; Timepoint(s): At 15 and 21 months 3. Cost utility analysis compare template & model plus template; Timepoint(s): At 3,6 and 12 and 21 months 4. Does training change HCP behaviour; Timepoint(s): Immediately after training and 6 months after training 5. Practice Level outcome measures: Frequency and pattern of Read coding of OA and joint pain; Timepoint(s): At 15 and 21 months 6. Practice Level outcome measures: Frequency of OA consultations with other health professionals; Timepoint(s): At 15 and 21 months 7. Practice Level outcome measures: Medication use for OA and joint pain; Timepoint(s): At 15 and 21 months 8. Prescription of a proton pump inhibitor (PPI) during NSAID therapy; Timepoint(s): At 15 and 21 months 9. Records of being offered information on exercise or activity; Timepoint(s): At 15 and 21 months 10. Records of being offered information on referral to a physiotherapist; Timepoint(s): At 15 and 21 months 11. Records of being offered information on referral to an exercise programme; Timepoint(s): At 15 and 21 months 12. Records of being offered information on the condition (OA); Timepoint(s): At 15 and 21 months 13. Topical NSAIDs prior to treatment with oral NSAIDs or opiate analges; Timepoint(s): At 15 and 21 months | — |
Countries
United Kingdom
Outcome results
None listed