BABS (Becoming Active in Beating osteoarthritiS): Study protocol of a randomized controlled trial on the effectiveness of an information campaign in improving the management of osteoarthritis and quality of care

Abstract

Background Despite recommendations, non-surgical treatment modalities in knee and/or hip osteoarthritis (KHOA) are underused. This article describes the development and content of an information campaign and the design of a randomized controlled trial (RCT) on the effectiveness of such a information campaign, targeting both KHOA patients and healthcare professionals (HCPs), on healthcare utilization. Methods The Behaviour Change Wheel (BCW) was used as a theoretical framework for the campaign design. After an inventory of the literature, a selection was made of factors influencing healthcare use. The campaign aims to increase 1) awareness and knowledge of patients and their HCPs about OA and treatment options, and 2) quality of communication and interdisciplinary collaboration. Main elements of the campaign include written materials and an educational program. Persuasive communication techniques (i.e., message framing, narratives) are embedded within the campaign to positively impact beliefs about conservative treatments. The effectiveness of the campaign will be evaluated with a cluster RCT. The study aims to recruit 300 patients in 24 general practices (GPs), randomly allocated to intervention or usual care (ratio 1:1). GPs and affiliated HCPs are invited to participate in the trial and recruit patients. Patients are eligible to participate if they are Dutch speaking, aged 50 to 75, registered with KHOA at the GP practice, without joint replacement nor having considerable walking impairment. The main endpoint is the difference in rate of referral to hospital care as reported by patients over a period of 18 months. Secondary parameters include quality of care, beliefs about KHOA treatment modalities, physical activity, self-management behavior, and referral rates to secondary care. Patients receive online questionnaires at baseline, 6, 12, and 18 months. Online questionnaires are sent to HCPs at baseline and after 12 months to assess (changes in) beliefs about KHOA treatment modalities, and qualitative interviews are performed with HCPs of the intervention group at 12 months to assess network collaboration. Conclusion This article reports on a systematic, theory-based approach, building a toolbox of evidence-based intervention strategies. Furthermore, the RCT will provide insight into the effectiveness of an information campaign on impacting patterns of healthcare consumption. Trial registration International Clinical Trial Registry Platform (ICTRP), trial number NL9140, registration date 23-12-2020