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

Funding

Government body,National Health and Medical Research Council (NHMRC)

Scientific enquiries

Dr Jocelyn Bowden

Brief Summary

The PARTNER project aims to implement and evaluate a new model of service delivery to improve the health of people with knee osteoarthritis (OA) in Australia. Currently, the day-to-day care of people with OA in Australia is inconsistent with care recommended in established clinical guidelines. Our new model focuses on both the person with OA and their general practitioner (GP). Firstly, the intervention will support GPs to gain an understanding of the effective conservative, non-surgical managem .... The PARTNER project aims to implement and evaluate a new model of service delivery to improve the health of people with knee osteoarthritis (OA) in Australia. Currently, the day-to-day care of people with OA in Australia is inconsistent with care recommended in established clinical guidelines. Our new model focuses on both the person with OA and their general practitioner (GP). Firstly, the intervention will support GPs to gain an understanding of the effective conservative, non-surgical management options available for treatment of patients with OA. GPs will be provided with professional development and training including audit/feedback, and electronic medical record decision support. Secondly, patients will receive advice and support on issues related to the management of OA including exercise, weight loss, pain management and other self-management behaviours. The intervention will be delivered remotely by a centralised, multidisciplinary team of health professionals trained in best-practice OA management. This ‘Care Support Team’ (CST) will also have skills in health coaching and behavioural change which will support patients to manage their knee OA, and will help the GP facilitate additional healthcare services if required. This project will implement and evaluate the proposed model of service delivery (PARTNER model) in a mixed methods study including a randomised controlled trial (RCT) in two Australian states with economic and qualitative evaluations. This trial will help us to better understand the effectiveness, feasibility, acceptability, sustainability and cost-effectiveness of the model. We are partnering with a range of academic, industry and professional health organisations to ensure optimal delivery of the model and to facilitate long-term implementation into the Australian healthcare system.
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Key Inclusion Criteria

We will recruit General Practices, GPs and their patients to participate in the trial. The criteria for each group is: a) General Practices Inclusion: • At least one GP from the practice agree to be involved. • The practice uses a general practice clinical desktop system compatible with the electronic medical record decision support tool (cdmNet). • Practice has current public liability insurance. • Practice consents to be randomised. b) GPs Inclusion: • Works in a participating practice. • Regi .... We will recruit General Practices, GPs and their patients to participate in the trial. The criteria for each group is: a) General Practices Inclusion: • At least one GP from the practice agree to be involved. • The practice uses a general practice clinical desktop system compatible with the electronic medical record decision support tool (cdmNet). • Practice has current public liability insurance. • Practice consents to be randomised. b) GPs Inclusion: • Works in a participating practice. • Registered and has current professional indemnity insurance. • Provides written informed consent. • Willing to undertake the study as per protocol. • Treats patients with knee OA. c) Patients Inclusion: These inclusion criteria are based on those recommended by the National Institute for Health and Care Excellence (NICE) Guidelines for Osteoarthritis Care and Management in Adults: • aged 45 years or older. • had activity related knee pain for at least 3 months. • has knee pain of 4 or greater on an 11-point numerical rating scale (NRS) at the time of screening. • are a patient of a GP recruited to the trial or agree to see a recruited GP in the same practice
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Key Exclusion Criteria

We will recruit General Practices, GPs and their patients to participate in the trial. The exclusion criteria for each group is: a) General Practices: • Participated in the pilot study. • The practice principal or practice manager refuses participation. • The practice does not have one or more GPs who treat patients with knee OA. b) GPs • Works at more than one of the general practices included in the trial. • Participated in the pilot study. c) Patients • non-English speaker or unable to give i .... We will recruit General Practices, GPs and their patients to participate in the trial. The exclusion criteria for each group is: a) General Practices: • Participated in the pilot study. • The practice principal or practice manager refuses participation. • The practice does not have one or more GPs who treat patients with knee OA. b) GPs • Works at more than one of the general practices included in the trial. • Participated in the pilot study. c) Patients • non-English speaker or unable to give informed consent (including patients in high level care, or with any medical condition which precludes giving informed consent (e.g. dementia, intellectual disability, mental health issues). • non-ambulatory or limited mobility. • has had knee replacement surgery in the affected knee or is booked for surgery. Patients may still be included if their other knee meets the inclusion criteria and it has not undergone a knee replacement. • is terminally ill, has rheumatoid arthritis or gout, or any other severe inflammatory condition, or is undergoing active treatment for serious medical conditions which would preclude participation in this study (e.g. cancer treatment).
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