Clinical trial NCT02876120: The STavanger osteoARThritis Study
Official title: The STavanger osteoARThritis Study in Primary Health Care
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Knee Osteoarthritis
Hip Osteoarthritis
Lead sponsor: Diakonhjemmet Hospital
Sponsor class: OTHER
Collaborators: name: Stavanger Municipality
name: Helse Stavanger HF
First posted: 2016-08-23
Enrollment: 330
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The START study will implement osteoarthritis (OA) treatment recommendations to increase the use of recommended treatment modalities and reduce non-desired events (e.g. unnecessary referrals to secondary care, unnecessary use of costly imaging modalities and use of treatment modalities supported by low quality of evidence). The purpose of the STavanger osteoARThritis (START) study is to improve the quality of OA care and increase the collaboration between health care professionals in primary health care and across health care levels.

Detailed description: 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. The purpose of the STavanger osteoARThritis (START) study is to improve the quality of OA care and increase the collaboration between health care professionals in primary health care and across health care levels.

Based on international treatment recommendations for OA care and previous research, a tailored implementation strategy targeting high quality, integrated care for people with OA in Stavanger Municipality will be developed, implemented and evaluated. The care will mainly be provided in the Stavanger primary health care services by physiotherapists (PT) (in private practice) and general practitioners (GP), but will also include collaboration with orthopaedic surgeons in specialist health care at Stavanger University Hospital.

The main aim of the present study is to develop, implement and evaluate effects of a tailored implementation strategy for the START study in Stavanger Municipality.

To evaluate the effects of the START implementation strategy, an interrupted time series design method will be applied. The study period will be divided into three phases: pre-implementation, implementation/transition and post-implementation. Data will be collected at 16 time points; 8 before and 8 after the implementation/ transition phase.

Eligibility criteria: Inclusion Criteria:

* PT working in private practice in Stavanger Municipality
* GP working in Stavanger Municipality
* Person with complaints due to hip and/or knee osteoarthritis referred to physiotherapy in Stavanger Municipality
* Person with complaints due to hip and/or knee osteoarthritis referred for assessment of joint replacement at Stavanger University Hospital

Exclusion Criteria:

* Persons referred to physiotherapy after a total joint replacement
* Persons who do not understand the Norwegian language
* Persons with cognitive dysfunction

Primary outcomes:
measure: Change in patient-reported quality of osteoarthritis care
timeFrame: 8 weeks pre-implementation vs. 8 weeks post-implementation
Secondary outcomes:
measure: Change in the number of PT discharge summaries to the referring GP
timeFrame: 8 weeks pre-implementation vs. 8 weeks post-implementation
measure: Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that has explored non-surgical treatment modalities beforehand
timeFrame: 8 weeks pre-implementation vs. 8 weeks post-implementation
measure: Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that has taken an MRI and/or conventional radiographs for OA assessment
timeFrame: 8 weeks pre-implementation vs. 8 weeks post-implementation
measure: Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that leads to scheduled joint surgery
timeFrame: 8 weeks pre-implementation vs. 8 weeks post-implementation
Other outcomes:
Locations:
Study officials:
affiliation: Diakonhjemmet Hospital
name: Nina Østerås
role: PRINCIPAL_INVESTIGATOR
References:
citation: Osteras N, Blaker IB, Hjortland T, Cottrell E, Quicke JG, Dziedzic KS, Blackburn S, Paulsen A. Improving osteoarthritis management in primary healthcare: results from a quasi-experimental study. BMC Musculoskelet Disord. 2021 Jan 14;22(1):79. doi: 10.1186/s12891-021-03959-6.