Barriers and enablers to the implementation of the Australian Osteoarthritis Chronic Care Program (OACCP)

Abstract

(CART) analysis was applied to the TKR AC appropriateness categories to determine the contribution of the predicted outcomes variables to appropriateness classification. Results: After orthopedic surgeons ruled out clinically implausible scenarios, the remaining 279 scenarios were classified as 71 inappropriate, 112 maybe appropriate, and 96 appropriate. Figure below shows the results of the CART analyses classification tree with the branches labeled with the key variables that discriminated among the classifications. The terminal nodes of each branch (highlighted in grey) indicate the final distribution of the ratings of appropriate (App), may be appropriate (Maybe App) and inappropriate (Inapp). CART analyses showed that all 3 predicted outcome factors and 2 of the clinical presentation factors (knee symptom severity and X-ray findings) were the variables that discriminated among the classifications. Conclusions: Our Results showed that predicted outcomes were utilized by clinicians when determining appropriateness for TKR. How these data influence the decision making of patients contemplating TKR should be investigated further. Purpose: International guidelines for first-line treatment of knee osteoarthritis (OA) include education, exercise, and weight-Abstracts / Osteoarthritis and Cartilage 28 (2020) S86eS527 S446

Barriers and enablers to uptake of a contemporary guideline-based management program for hip and knee osteoarthritis: A qualitative study

“…Health service barriers include limited capacity and constraints (e.g. physical space, administrative support, funding restrictions) to implement programs and enablers include support from key stakeholders and clinical champions [ 17 ].…”

“…While previous qualitative studies have provided insight into the potential barriers and enablers to uptake of osteoarthritis management programs from patients and medical professional perspectives [ [15] , [16] , [17] ], and the components of care [ [18] , [19] , [20] , [21] , [22] , [23] , [24] ], these results may not be generalisable to contemporary programs available internationally, such as GLA:D [ 1 ]. Additionally, using a validated behaviour change theory such as the theoretical domains framework [ 25 , 26 ], can enable a more in-depth exploration of the potential barriers and enablers for referrals to, and participation in osteoarthritis management programs among patients and potential referrers.…”

Osteoarthritis management care pathways are complex and inefficient: A qualitative study of physiotherapist perspectives from specialised osteoarthritis services

“…The varying models of care in osteoarthritis services within Australia reflect variations seen internationally, with an optimal model yet to be identified (Allen et al, 2016). Although OACCP has been reported to reduce the patient willingness for surgery (Teoh et al, 2017), OACCP physiotherapists in this study and previous research (Eyles et al, 2020) expressed a desire to alter the pathway so that patients would be seen prior to being wait-listed for surgery.…”

Unmet Needs in the Osteoarthritis Chronic Moderate to Severe Pain Management in Spain: A Real Word Data Study

“…The holistic management of patients with OA, through the implementation of medical programs specifically designed for these patients, could significantly improve the outcomes currently achieved in Spain. These initiatives, like the “Osteoarthritis Chronic Care Program (OACCP)” in Australia [ 21 , 22 ], “Better Management of Patients with Osteoarthritis (BOA)” program in Sweden [ 23 , 24 ], “Enabling Self-Management and Coping with Arthritic Pain using Exercise (ESCAPE)” program in the UK [ 25 ] and “Good Life with Osteoarthritis in Denmark (CLA:D)” program in Denmark [ 26 ], are best practices for delivering the core treatment strategy recommended by the OA guidelines worldwide, which involve the patient in their self-management and give physiotherapists, occupational therapists and nutritionists an important role in patient care.…”

“…Which interventions and the order in which interventions are used will vary among patient phenotypes [ 17 ]. In reference to this, different experiences exist worldwide about how to adequately organize the core treatment delivery for patients with OA, such as the programs carried out in Australia [ 21 , 22 ], Sweden [ 23 , 24 ], the UK [ 25 ] and Denmark [ 26 ]. To our knowledge, no attempts similar to these experiences have been made in Spain.…”