Hip Osteoarthritis, Knee Osteoarthritis
Conditions
Brief summary
The START study will implement osteoarthritis (OA) treatment recommendations to increase the use of recommended treatment modalities and reduce non-desired events (e.g. unnecessary referrals to secondary care, unnecessary use of costly imaging modalities and use of treatment modalities supported by low quality of evidence). The purpose of the STavanger osteoARThritis (START) study is to improve the quality of OA care and increase the collaboration between health care professionals in primary health care and across health care levels.
Detailed description
Previous research has shown that the osteoarthritis care for persons with hip or knee osteoarthritis in Norway has a potential for improvement as the provided care may not necessarily reflect evidence-based guideline recommendations. The purpose of the STavanger osteoARThritis (START) study is to improve the quality of OA care and increase the collaboration between health care professionals in primary health care and across health care levels. Based on international treatment recommendations for OA care and previous research, a tailored implementation strategy targeting high quality, integrated care for people with OA in Stavanger Municipality will be developed, implemented and evaluated. The care will mainly be provided in the Stavanger primary health care services by physiotherapists (PT) (in private practice) and general practitioners (GP), but will also include collaboration with orthopaedic surgeons in specialist health care at Stavanger University Hospital. The main aim of the present study is to develop, implement and evaluate effects of a tailored implementation strategy for the START study in Stavanger Municipality. To evaluate the effects of the START implementation strategy, an interrupted time series design method will be applied. The study period will be divided into three phases: pre-implementation, implementation/transition and post-implementation. Data will be collected at 16 time points; 8 before and 8 after the implementation/ transition phase.
Interventions
OTHERImplementation
Multifaceted implementation strategy to implement evidence based international osteoarthritis treatment recommendations among GPs and PTs in private practice, template for PT discharge reports to GP, patient osteoarthritis education programs, and facilitate multidisciplinary collaboration between the PTs and GPs.
Sponsors
Stavanger Municipality
Helse Stavanger HF
Diakonhjemmet Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* PT working in private practice in Stavanger Municipality * GP working in Stavanger Municipality * Person with complaints due to hip and/or knee osteoarthritis referred to physiotherapy in Stavanger Municipality * Person with complaints due to hip and/or knee osteoarthritis referred for assessment of joint replacement at Stavanger University Hospital
Exclusion criteria
* Persons referred to physiotherapy after a total joint replacement * Persons who do not understand the Norwegian language * Persons with cognitive dysfunction
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in patient-reported quality of osteoarthritis care | 8 weeks pre-implementation vs. 8 weeks post-implementation | Using the OsteoArthritis Quality Indicator questionnaire |
Secondary
| Measure | Time frame |
|---|---|
| Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that leads to scheduled joint surgery | 8 weeks pre-implementation vs. 8 weeks post-implementation |
| Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that has taken an MRI and/or conventional radiographs for OA assessment | 8 weeks pre-implementation vs. 8 weeks post-implementation |
| Change in the number of PT discharge summaries to the referring GP | 8 weeks pre-implementation vs. 8 weeks post-implementation |
| Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that has explored non-surgical treatment modalities beforehand | 8 weeks pre-implementation vs. 8 weeks post-implementation |
Outcome results
None listed