Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY
Abstract Background To increase the uptake of key clinical recommendations for non-surgical management of knee osteoarthritis (OA) and improve patient outcomes, we developed a new model of service delivery (PARTNER model) and an intervention to implement the model in the Australian primary care sett...
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| Format: | Article |
| Language: | English |
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BMC
2018-04-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-018-2048-0 |
| _version_ | 1830093105511006208 |
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| author | David J. Hunter Rana S. Hinman Jocelyn L. Bowden Thorlene Egerton Andrew M. Briggs Stephen J. Bunker Jessica Kasza Andrew B. Forbes Simon D. French Marie Pirotta Deborah J. Schofield Nicholas A. Zwar Kim L. Bennell the PARTNER Study Team |
| author_facet | David J. Hunter Rana S. Hinman Jocelyn L. Bowden Thorlene Egerton Andrew M. Briggs Stephen J. Bunker Jessica Kasza Andrew B. Forbes Simon D. French Marie Pirotta Deborah J. Schofield Nicholas A. Zwar Kim L. Bennell the PARTNER Study Team |
| author_sort | David J. Hunter |
| collection | DOAJ |
| description | Abstract Background To increase the uptake of key clinical recommendations for non-surgical management of knee osteoarthritis (OA) and improve patient outcomes, we developed a new model of service delivery (PARTNER model) and an intervention to implement the model in the Australian primary care setting. We will evaluate the effectiveness and cost-effectiveness of this model compared to usual general practice care. Methods We will conduct a mixed-methods study, including a two-arm, cluster randomised controlled trial, with quantitative, qualitative and economic evaluations. We will recruit 44 general practices and 572 patients with knee OA in urban and regional practices in Victoria and New South Wales. The interventions will target both general practitioners (GPs) and their patients at the practice level. Practices will be randomised at a 1:1 ratio. Patients will be recruited if they are aged ≥45 years and have experienced knee pain ≥4/10 on a numerical rating scale for more than three months. Outcomes are self-reported, patient-level validated measures with the primary outcomes being change in pain and function at 12 months. Secondary outcomes will be assessed at 6 and 12 months. The implementation intervention will support and provide education to intervention group GPs to deliver effective management for patients with knee OA using tailored online training and electronic medical record support. Participants with knee OA will have an initial GP visit to confirm their diagnosis and receive management according to GP intervention or control group allocation. As part of the intervention group GP management, participants with knee OA will be referred to a centralised multidisciplinary service: the PARTNER Care Support Team (CST). The CST will be trained in behaviour change support and evidence-based knee OA management. They will work with patients to develop a collaborative action plan focussed on key self-management behaviours, and communicate with the patients’ GPs. Patients receiving care by intervention group GPs will receive tailored OA educational materials, a leg muscle strengthening program, and access to a weight-loss program as appropriate and agreed. GPs in the control group will receive no additional training and their patients will receive usual care. Discussion This project aims to address a major evidence-to-practice gap in primary care management of OA by evaluating a new service delivery model implemented with an intervention targeting GP practice behaviours to improve the health of people with knee OA. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12617001595303, date of registration 1/12/2017. |
| first_indexed | 2024-12-16T17:49:32Z |
| format | Article |
| id | doaj.art-547e5eeaefb64d52aaf01cdb1b51a912 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-16T17:49:32Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-547e5eeaefb64d52aaf01cdb1b51a9122022-12-21T22:22:22ZengBMCBMC Musculoskeletal Disorders1471-24742018-04-0119111610.1186/s12891-018-2048-0Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDYDavid J. Hunter0Rana S. Hinman1Jocelyn L. Bowden2Thorlene Egerton3Andrew M. Briggs4Stephen J. Bunker5Jessica Kasza6Andrew B. Forbes7Simon D. French8Marie Pirotta9Deborah J. Schofield10Nicholas A. Zwar11Kim L. Bennell12the PARTNER Study TeamInstitute of Bone and Joint Research, Kolling Institute, University of SydneyCentre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of MelbourneInstitute of Bone and Joint Research, Kolling Institute, University of SydneyCentre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of MelbourneSchool of Physiotherapy and Exercise Science, Curtin UniversityDepartment of Physiotherapy, The University of MelbourneBiostatistics Unit, School of Public Health and Preventive Medicine, Monash UniversityBiostatistics Unit, School of Public Health and Preventive Medicine, Monash UniversitySchool of Rehabilitation Therapy, Queen’s UniversityDepartment of General Practice, The University of MelbourneDepartment of Economics, Faculty of Business and Economics, Macquarie UniversitySchool of Public Health and Community Medicine, University of New South WalesCentre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of MelbourneAbstract Background To increase the uptake of key clinical recommendations for non-surgical management of knee osteoarthritis (OA) and improve patient outcomes, we developed a new model of service delivery (PARTNER model) and an intervention to implement the model in the Australian primary care setting. We will evaluate the effectiveness and cost-effectiveness of this model compared to usual general practice care. Methods We will conduct a mixed-methods study, including a two-arm, cluster randomised controlled trial, with quantitative, qualitative and economic evaluations. We will recruit 44 general practices and 572 patients with knee OA in urban and regional practices in Victoria and New South Wales. The interventions will target both general practitioners (GPs) and their patients at the practice level. Practices will be randomised at a 1:1 ratio. Patients will be recruited if they are aged ≥45 years and have experienced knee pain ≥4/10 on a numerical rating scale for more than three months. Outcomes are self-reported, patient-level validated measures with the primary outcomes being change in pain and function at 12 months. Secondary outcomes will be assessed at 6 and 12 months. The implementation intervention will support and provide education to intervention group GPs to deliver effective management for patients with knee OA using tailored online training and electronic medical record support. Participants with knee OA will have an initial GP visit to confirm their diagnosis and receive management according to GP intervention or control group allocation. As part of the intervention group GP management, participants with knee OA will be referred to a centralised multidisciplinary service: the PARTNER Care Support Team (CST). The CST will be trained in behaviour change support and evidence-based knee OA management. They will work with patients to develop a collaborative action plan focussed on key self-management behaviours, and communicate with the patients’ GPs. Patients receiving care by intervention group GPs will receive tailored OA educational materials, a leg muscle strengthening program, and access to a weight-loss program as appropriate and agreed. GPs in the control group will receive no additional training and their patients will receive usual care. Discussion This project aims to address a major evidence-to-practice gap in primary care management of OA by evaluating a new service delivery model implemented with an intervention targeting GP practice behaviours to improve the health of people with knee OA. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12617001595303, date of registration 1/12/2017.http://link.springer.com/article/10.1186/s12891-018-2048-0Primary careKnee osteoarthritisModel of service deliveryRCTClinical trial |
| spellingShingle | David J. Hunter Rana S. Hinman Jocelyn L. Bowden Thorlene Egerton Andrew M. Briggs Stephen J. Bunker Jessica Kasza Andrew B. Forbes Simon D. French Marie Pirotta Deborah J. Schofield Nicholas A. Zwar Kim L. Bennell the PARTNER Study Team Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY BMC Musculoskeletal Disorders Primary care Knee osteoarthritis Model of service delivery RCT Clinical trial |
| title | Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY |
| title_full | Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY |
| title_fullStr | Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY |
| title_full_unstemmed | Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY |
| title_short | Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY |
| title_sort | effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis protocol for the partner study |
| topic | Primary care Knee osteoarthritis Model of service delivery RCT Clinical trial |
| url | http://link.springer.com/article/10.1186/s12891-018-2048-0 |
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