An interventional study of New OA model in Hip Osteoarthritis and Knee Osteoarthritis, sponsored by Diakonhjemmet Hospital. Completed at 1 site in Norway. Open to participants aged 45 Years and older. Per ClinicalTrials.gov, last updated 2018-02-01.
Sponsored by Diakonhjemmet Hospital · Not applicable, Interventional, and Health services research
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. This study will determine if a new model for integrated osteoarthritis (OA) care in primary health care will result in improved quality of osteoarthritis care and health benefits for the patients (reduced pain and body weight, increased function and activity level) among patients with hip and/or knee osteoarthritis. Further, this study will examine if the new model reduce the number of unnecessary referrals to Magnetic Resonance Imaging (MRI) and to orthopaedic surgeons in secondary care, and if it increases the number of referrals to physiotherapy treatment and the number of discharge reports from the physiotherapists to the referring general practitioner.
A new model for integrated care for patients with hip and/or knee osteoarthritis (OA) in primary care will be developed and implemented. The purpose of the model is to improve quality of OA care in primary health care services by increasing the collaboration between health care professionals and across health care levels, providing an integrated care and a patient pathway, and facilitating an active and healthy lifestyle among individuals with OA. This implementation study represents a collaborative study between six municipalities and a hospital department aiming to fulfill the intentions of the Norwegian Health Care Coordination Reform. The main aim of the present study is to implement and perform process and effect evaluations of this new model for integrated OA care. The study design will be a cluster randomized controlled trial with a stepped wedge design. Six neighboring municipalities will constitute the six clusters, which will switch from control (current OA care) to intervention phase (new OA model) in a randomized order. All municipalities start the trial simultaneously and act as controls until the point in time they are randomized to crossover from control to intervention, and all municipalities have implemented the intervention by the end of inclusion. The method consists of two parts; 1) Identification of barriers/facilitators + development of the model and interventions, 2) Implementation of the new model (interactive workshops) with process and effect evaluations. Participants will be general practitioners and physiotherapists in primary care as well as people with hip or knee OA.
4,398 studies on the registry are indexed under Osteoarthritis; 582 are open to participants now.
This study's enrollment of 393 is above the median of 70 across 3,440 interventional studies indexed under Osteoarthritis.
Browse Osteoarthritis studies →Diakonhjemmet Hospital is the lead sponsor of 62 studies on the registry; 15 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Usual care. The participants enrolled in the control period will receive OA treatment as it is currently offered in primary health care services.
New OA model. Health professionals attend an interactive workshop, implementation of international recommendations for OA care, multidiciplinary collaboration
Other: New OA model
The general practitioners and the physiotherapists will attend an inter-active workshop and deliver osteoarthritis care in line with international recommendations for osteoarthritis treatment. The general practitioner will refer eligible patients to treatment by physiotherapists at "Healthy Living Center" or by physiotherapists in private practice. This treatment will include a standardized patient education program followed by structured exercise program with individual adjustments. The general practitioner will schedule a follow-up after the 12-week treatment and will receive a treatment report from the physiotherapist.
Osteoarthritis Quality Indicator questionnaire
Patient reported achievement of quality indicators for osteoarthritis care
Time frame: 6 months
Pain
Pain level in hip/knee past week
Time frame: 6 months
Joint stiffness
Stiffness in the hip/knee past week
Time frame: 6 months
Global function
Hip/knee function in the past week
Time frame: 6 months
Patient global assessment of the OA disease
Time frame: 6 months
Patient Acceptable Symptom State (PASS)
Time frame: 6 months
Hip/knee function, quality of living subscale
Function (Knee injury and Osteoarthritis Outcome Score ADL subscale/ Hip disability and Osteoarthritis Outcome Score OoL subscale (K/HOOS)
Time frame: 6 months
Physical activity level
An index based on self-reported frequency, intensity, duration of physical activity
Time frame: 6 months
Daily sitting
Daily hours in sitting position
Time frame: 6 months
Satisfaction with the care provided
Time frame: 6 months
Health related quality of life (EQ-5D)
Time frame: 6 months
Self-reported body weight
Time frame: 6 months
Health care use, medication use and sick leave
Time frame: 6 months
Adverse events
Time frame: Up to 1 year
Health professionals' knowledge, attitude and behavior in OA care
Time frame: Pre- and post-workshop + 6 months post-workshop
Referrals to orthopaedic surgeons
Number of referrals to secondary care that does not lead to scheduled joint surgery
Time frame: Up to 1 year
Referrals to MRI
Number of referrals to MRI for OA assessment
Time frame: Up to 1 year
Number of referrals to physiotherapy treatment
Time frame: Up to 1 year
Discharge reports from physiotherapists
Number of discharge reports from PTs at FLSs/ private practice to the referring GP
Time frame: Up to 1 year
Arthritis Self-efficacy Scale
Time frame: 6 months
This study is completed, as verified in Jan 2018. You cannot join it, but the record below documents what was studied.
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Diakonhjemmet Hospital