@article{9a31695a10214fe7ba70194e43c5a8a8,
title = "Effectiveness of a new service delivery model for management of knee osteoarthritis in primary care: a cluster randomised controlled trial",
abstract = "Objective: Evaluate the effectiveness and health costs of a new primary care service delivery model (PARTNER) to improve health outcomes for people with knee osteoarthritis (OA), compared to usual care. Methods: A two-arm, cluster, superiority randomised controlled trial with randomisation at the general practice level, undertaken in Victoria and New South Wales, Australia. We aimed to recruit 44 practices and 572 patients aged ≥45 years with knee pain for >3 months. Professional development opportunities on best-practice OA care were provided to intervention group GPs. All recruited patients had an initial GP visit to confirm knee OA diagnosis. Control patients continued usual GP care and intervention patients were referred to a centralised Care Support Team (CST), for 12-months. Via telehealth, the CST provided OA education and an agreed OA action plan focused on muscle strengthening, physical activity, and weight-management. Primary outcomes were patient self-reported change in knee pain (numerical rating scale, 0-10=worse) and physical function (KOOS Activities of Daily Living subscale, 0-100=better), at 12-months. Healthcare costs outcomes included costs of medical visits and prescription medications over the 12-month period. Results: Recruitment targets were not reached. 38 practices and 217 patients were recruited. The intervention improved pain by 0.8/10 points (95% CI 0.2 to 1.4), and function by 6.5/100 points (95% CI 2.3 to 10.7), more than usual care at 12-months. Total costs of medical visits and prescriptions were $3,940 for the intervention group versus $4,161 for usual care. This difference was not statistically significant. Conclusion: The PARTNER model improved knee pain and function more than usual GP care. The magnitude of improvement is unlikely to be clinically meaningful for pain but is uncertain for function.",
author = "Hunter, {David J.} and Bowden, {Jocelyn L.} and Hinman, {Rana S.} and Thorlene Egerton and Briggs, {Andrew M.} and Bunker, {Stephen J.} and French, {Simon D.} and Marie Pirotta and Rupendra Shrestha and Schofield, {Deborah J.} and Karen Schuck and Zwar, {Nicholas A.} and Silva, {S. Sandun M.} and Heller, {Gillian Z.} and Bennell, {Kim L.} and {PARTNER Study Team}",
note = "Funding Information: We thank all our stakeholders, partner organizations, members of the PARTNER working groups, the steering committee, and the data safety monitoring board for their input into the model and the study protocol design and overseeing the safety of the trial. In particular: Ms. Franca Marine and Ms. Ainslie Cahill, Arthritis Australia (educational materials and advice), Ms. Janette Gale and Ms. Caroline Bills, HealthChange Australia (training for the CST and provision of manuals), Precedence Health Care (Inca software and training), Dr. Kevin Cheng and Ms. Rebecca Bell, Medibank Private, Ms. Sonia Dixon, Medibank Better Health Foundation, Ms. Natalie Dubrowin, Bupa Australia, nib Health Funds, Dr. Andrew Cottrill, HCF, the Digital Wellness Team (for delivering the CSIRO Total Wellbeing Diet program and support), and the Victorian Primary Care Practice-Based Research Network (the University of Melbourne) and the NSW Primary Health Care Research Network (University of NSW). We give special thanks to all the staff and patients at the participating general practices, the GP clinical research network teams (Michelle King, Anna Wood, Janet Cook, Iqbal Hasan, and Rebecca Doyle), and the administrative staff at the University of NSW and the University of Melbourne who provided support to the general practices involved in the study. A special thanks to Jessica Kasza and Andrew Forbes, Monash University, for their input into the statistical design of the study. Finally, we thank and gratefully acknowledge the invaluable contribution of the PARTNER study team and the PARTNER CST: Karen Schuck, Charlotte Marshall, Stephanie Hawkins, Libby Spiers, Carin Pratt, Kelly Woosnam, Jane Evans, Elizabeth Dixon, Kim Allison, Heidi Williams, and Hayley Morey. We acknowledge the participating GPs for their support and involvement in the trial: Dr. K. Ahmed, Dr. D. Allen, Dr. A. Aran, Dr. A. Bowes, Dr. M. Bryce, Dr. S. Butler, Dr. N. Carr, Dr. I. Chia, Dr. S. Chu, Dr. A. Cotter, Dr. T. Cox, Dr. O. Doorbinnia, Dr. N. Doyle, Dr. M. Eagle, Dr. A. Elkafrawi, Dr. J. Epstein, Dr. N. Fuertes, Dr. L. Gallo, Dr. K. Goring-Siebert, Dr. V. Goyal, Dr. G. Heron, Dr. C. Hollier, Dr. B. Johnston, Dr. A. Keane, Dr. J. Lee, Dr. G. Manku, Dr. Q. Minh Phan, Dr. S. Muller, Dr. H. Nespolon, Dr. N. Obeid, Dr. P. O'Halloran, Dr. C Ovadia, Dr. M Pakthagurunathan, Dr. A Perlesz, Dr. A Pham, Dr. E Pritchard, Dr. S Pugh, Dr. P. Russell, Dr. A. Saddik, Dr. P. Singh, Dr. D. Smith, Dr. W. Sorial, Dr. J. Stephenson, Dr. E. Stoddart, Dr. L. Susino, Dr. N. Titova, Dr. S. Trebble, Dr. T. Van Haren, Dr. T. Van Kesteren, Dr. R. Venkatesan, and Dr. D. Wilson. Open access publishing facilitated by The University of Sydney, as part of the Wiley - The University of Sydney agreement via the Council of Australian University Librarians. Publisher Copyright: {\textcopyright} 2022 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology.",
year = "2023",
month = jun,
doi = "10.1002/acr.25037",
language = "English",
volume = "75",
pages = "1320--1332",
journal = "Arthritis care and research : the official journal of the Arthritis Health Professions Association",
issn = "0004-3591",
publisher = "John Wiley & Sons",
number = "6",
}