This project aims to bridge the gap between guideline recommendations and clinical practice in osteoarthritis (OA) management. By implementing a systematic, evidence-based model of care, the project seeks to improve patient outcomes, reduce healthcare costs, and provide equitable access to care. The project consists of three phases. In the first phase the current OA care is mapped through registry review and questionnaires and interviews of patients and healthcare professionals. In the second, implementation phase of the project, a plan will be created how to support healthcare professionals in delivering care according to the new model of care and training and support will be offered according to the plan. In the third phase of the project, the implementation success will be evaluated, and the costs of OA care evaluated and compared to baseline data. In addition, patient-reported data will be collected from those patients, who participate in the group-based exercise and education program.
Patients with diagnosed OA (ICD-10 / ICPC2)
age over 18 years
Patients who are participating in theGLA:D program, diagnosed with hip or knee osteoarthritis, fluent in finnish
age over 18 years
Other than OA-related cause of symptoms
not able to answer the questionnaires in Finnish
no access to a computer or mobile device to answer the questionnaires
National registry data: Patients with diagnosed OA from all Wellbeing Services Counties in Finland GLA:D patient-reported outcome data: Patients who are participating in the GLA:D program, diagnosed with hip or knee osteoarthritis in any location that delivers GLA:D program.
Other
Prospective
Implementation of a guideline-based model of care for hip and knee osteoarthritis
BehavioralGuideline-based model of care including GLA:D (Good Life with osteoArthritis from Denmark) -program that includes training for physiotherapists and group based education and exercise for patients with hip and knee OA.
Cost of OA care
Healthcare cost associated with the new care pathway incluing annual healthcare consultation prevalence, number and cost of hospitalizations, OA-related surgical interventions and primary and specialized healthcare and outpatient specialist visits. Filled prescriptions, number and duration of OA-related sick leaves and disability pensions. Costs will be analysed using data from national registers in pre and post implementation, both within the pilot Wellbeing Services Counties and between the pilot and other Wellbeing Services Counties.
Reach: Proportion of patients directed according to the model of care
Proportion of patients with hip and knee related symptoms and OA who contact healthcare that are referred to direct access physiotherapy and to GLA:D program
Number of trained GLA:D trainers and physiotherapists
Number of trained GLA:D trainers and physiotherapists in Finland, recorded in GLA:D Finland database by PI.
Participation of patients in GLA:D program
Number of participants in GLA:D groups
Pain intensity during last week, numerical rating scale
Numerical rating scale (NRS) 0-10, where 0 means no pain (better outcome) and 10 worst possible pain (worse outcome). a) worst pain b) average pain
Problems walking due to knee /hip
yes / no
The Determinants of Implementation Behaviour Questionnaire
The multiprofessional version of Determinants of Implementation Behaviour Questionnaire (DIBQ-mp) Clinician reported determinants of implementation of guideline-based model of care and GLA:D program, designed according to the Theoretical Domains Framework. The items will be scored each separately on 7-point likert scale, where a lower score indicates that item being a barrier (worse outcome) and higher score towards facilitator (better outcome).
Gender
Male / female / other
Age
in years
Living situation
Living alone or with others
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University of Jyvaskyla
Lead sponsor
University of Southern Denmark
Collaborator
University of Oulu
Collaborator
University of Helsinki
Collaborator
Tampere University
Collaborator
University of Limerick
Collaborator
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