Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for the PARTNER STUDY

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, Karen Shuck, Charlotte Marshall, Michelle King, Anna Wood

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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.

Original languageEnglish
Article number132
JournalBMC Musculoskeletal Disorders
Volume19
Issue number1
DOIs
Publication statusPublished - 30 Apr 2018
Externally publishedYes

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Knee Osteoarthritis
General Practitioners
Primary Health Care
Knee
Pain
General Practice
Osteoarthritis
Cost-Benefit Analysis
Weight Reduction Programs
Control Groups
New South Wales
Victoria
Electronic Health Records
Self Care
New Zealand
Registries
Leg
Patient Care
Arm
Randomized Controlled Trials

Cite this

Hunter, David J. ; Hinman, Rana S. ; Bowden, Jocelyn L. ; Egerton, Thorlene ; Briggs, Andrew M. ; Bunker, Stephen J. ; Kasza, Jessica ; Forbes, Andrew B. ; French, Simon D. ; Pirotta, Marie ; Schofield, Deborah J. ; Zwar, Nicholas A. ; Bennell, Kim L. ; Shuck, Karen ; Marshall, Charlotte ; King, Michelle ; Wood, Anna. / Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis : Protocol for the PARTNER STUDY. In: BMC Musculoskeletal Disorders. 2018 ; Vol. 19, No. 1.
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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.",
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Hunter, DJ, Hinman, RS, Bowden, JL, Egerton, T, Briggs, AM, Bunker, SJ, Kasza, J, Forbes, AB, French, SD, Pirotta, M, Schofield, DJ, Zwar, NA, Bennell, KL, Shuck, K, Marshall, C, King, M & Wood, A 2018, '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, vol. 19, no. 1, 132. https://doi.org/10.1186/s12891-018-2048-0

Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis : Protocol for the PARTNER STUDY. / Hunter, David J.; Hinman, Rana S.; Bowden, Jocelyn L.; Egerton, Thorlene; Briggs, Andrew M.; Bunker, Stephen J.; Kasza, Jessica; Forbes, Andrew B.; French, Simon D.; Pirotta, Marie; Schofield, Deborah J.; Zwar, Nicholas A.; Bennell, Kim L.; Shuck, Karen; Marshall, Charlotte; King, Michelle; Wood, Anna.

In: BMC Musculoskeletal Disorders, Vol. 19, No. 1, 132, 30.04.2018.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis

T2 - Protocol for the PARTNER STUDY

AU - Hunter, David J.

AU - Hinman, Rana S.

AU - Bowden, Jocelyn L.

AU - Egerton, Thorlene

AU - Briggs, Andrew M.

AU - Bunker, Stephen J.

AU - Kasza, Jessica

AU - Forbes, Andrew B.

AU - French, Simon D.

AU - Pirotta, Marie

AU - Schofield, Deborah J.

AU - Zwar, Nicholas A.

AU - Bennell, Kim L.

AU - Shuck, Karen

AU - Marshall, Charlotte

AU - King, Michelle

AU - Wood, Anna

PY - 2018/4/30

Y1 - 2018/4/30

N2 - 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.

AB - 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.

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