PARTNER: a Service Delivery Model to Implement Optimal Primary Care Management of People with Knee Osteoarthritis: Description of Development

Overview

Journal BMJ Open

Specialty General Medicine

Date 2020 Oct 9

PMID 33033032

Citations 3

Authors

Thorlene Egerton

Rana S Hinman

David J Hunter

Jocelyn L Bowden

Philippa J A Nicolson

Lou Atkins

Marie Pirotta

Kim L Bennell

Affiliations

Soon will be listed here.

Abstract

Objective: Implementation strategies, such as new models of service delivery, are needed to address evidence practice gaps. This paper describes the process of developing and operationalising a new model of service delivery to implement recommended care for people with knee osteoarthritis (OA) in a primary care setting.

Methods: Three development stages occurred concurrently and iteratively. Each stage considered the healthcare context and was informed by stakeholder input. Stage 1 involved the design of a new model of service delivery (PARTNER). Stage 2 developed a behavioural change intervention targeting general practitioners (GPs) using the behavioural change wheel framework. In stage 3, the 'Care Support Team' component of the service delivery model was operationalised.

Results: The focus of PARTNER is to provide patients with education, exercise and/or weight loss advice, and facilitate effective self-management through behavioural change support. Stage 1 model design: based on clinical practice guidelines, known evidence practice gaps in current care, chronic disease management frameworks, input from stakeholders and the opportunities and constraints afforded by the Australian primary care context, we developed the PARTNER service-delivery model. The key components are: (1) an effective GP consultation and (2) follow-up and ongoing care provided remotely (telephone/email/online resources) by a 'Care Support Team'. Stage 2 GP behavioural change intervention: a multimodal behavioural change intervention was developed comprising a self-audit/feedback activity, online professional development and desktop software to provide decision support, patient information resources and a referral mechanism to the 'Care Support Team'. Stage 3 operationalising the 'care support team'-staff recruited and trained in evidence-based knee OA management and behavioural change methodology.

Conclusion: The PARTNER model is the result of a comprehensive implementation strategy development process using evidence, behavioural change theory and intervention development guidelines. Technologies for scalable delivery were harnessed and new primary evidence was generated as part of the process. ACTRN12617001595303 (UTN U1111-1197-4809).

Citing Articles

Effectiveness of a New Service Delivery Model for Management of Knee Osteoarthritis in Primary Care: A Cluster Randomized Controlled Trial.

Hunter D, Bowden J, Hinman R, Egerton T, Briggs A, Bunker S Arthritis Care Res (Hoboken). 2022; 75(6):1320-1332.

PMID: 36205225 PMC: 10952211. DOI: 10.1002/acr.25037.

Barriers and facilitators to the implementation of osteoarthritis management programmes in primary or community care settings: a systematic review and qualitative framework synthesis protocol.

Cunningham J, Briggs A, Cottrell E, Doyle F, Dziedzic K, Finney A HRB Open Res. 2021; 4:102.

PMID: 34746643 PMC: 8543168. DOI: 10.12688/hrbopenres.13377.1.

Primary care-based models of care for osteoarthritis: a scoping review protocol.

Cunningham J, Doyle F, Ryan J, Clyne B, Cadogan C, Cottrell E HRB Open Res. 2021; 4:48.

PMID: 34291185 PMC: 8264805. DOI: 10.12688/hrbopenres.13260.2.

References

Hunter D, Nicolson P, Little C, Robbins S, Wang X, Bennell K . Developing strategic priorities in osteoarthritis research: Proceedings and recommendations arising from the 2017 Australian Osteoarthritis Summit. BMC Musculoskelet Disord. 2019; 20(1):74. PMC: 6375218. DOI: 10.1186/s12891-019-2455-x. View

Porcheret M, Jordan K, Jinks C, Croft P . Primary care treatment of knee pain--a survey in older adults. Rheumatology (Oxford). 2007; 46(11):1694-700. DOI: 10.1093/rheumatology/kem232. View

Ivers N, Sales A, Colquhoun H, Michie S, Foy R, Francis J . No more 'business as usual' with audit and feedback interventions: towards an agenda for a reinvigorated intervention. Implement Sci. 2014; 9:14. PMC: 3896824. DOI: 10.1186/1748-5908-9-14. View

Hollinghurst S, Coast J, Busby J, Bishop A, Foster N, Franchini A . A pragmatic randomised controlled trial of 'PhysioDirect' telephone assessment and advice services for patients with musculoskeletal problems: economic evaluation. BMJ Open. 2013; 3(10):e003406. PMC: 3796275. DOI: 10.1136/bmjopen-2013-003406. View

Edwards J, Khanna M, Jordan K, Jordan J, Bedson J, Dziedzic K . Quality indicators for the primary care of osteoarthritis: a systematic review. Ann Rheum Dis. 2013; 74(3):490-8. PMC: 4345981. DOI: 10.1136/annrheumdis-2013-203913. View

Rosemann T, Wensing M, Joest K, Backenstrass M, Mahler C, Szecsenyi J . Problems and needs for improving primary care of osteoarthritis patients: the views of patients, general practitioners and practice nurses. BMC Musculoskelet Disord. 2006; 7:48. PMC: 1524764. DOI: 10.1186/1471-2474-7-48. View

Buchbinder R, Harris I . Arthroscopy to treat osteoarthritis of the knee?. Med J Aust. 2012; 197(7):364-5. DOI: 10.5694/mja12.11201. View

Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008; 42(2):377-81. PMC: 2700030. DOI: 10.1016/j.jbi.2008.08.010. View

Hunt M, Birmingham T, Skarakis-Doyle E, Vandervoort A . Towards a biopsychosocial framework of osteoarthritis of the knee. Disabil Rehabil. 2007; 30(1):54-61. DOI: 10.1080/09638280701189960. View

10.

McAlindon T, Bannuru R, Sullivan M, Arden N, Berenbaum F, Bierma-Zeinstra S . OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014; 22(3):363-88. DOI: 10.1016/j.joca.2014.01.003. View

11.

Smith S, Soubhi H, Fortin M, Hudon C, ODowd T . Interventions for improving outcomes in patients with multimorbidity in primary care and community settings. Cochrane Database Syst Rev. 2012; (4):CD006560. DOI: 10.1002/14651858.CD006560.pub2. View

12.

Conaghan P, Porcheret M, Kingsbury S, Gammon A, Soni A, Hurley M . Impact and therapy of osteoarthritis: the Arthritis Care OA Nation 2012 survey. Clin Rheumatol. 2014; 34(9):1581-8. DOI: 10.1007/s10067-014-2692-1. View

13.

Goode A, Reeves M, Eakin E . Telephone-delivered interventions for physical activity and dietary behavior change: an updated systematic review. Am J Prev Med. 2011; 42(1):81-8. DOI: 10.1016/j.amepre.2011.08.025. View

14.

Bannuru R, Osani M, Vaysbrot E, Arden N, Bennell K, Bierma-Zeinstra S . OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019; 27(11):1578-1589. DOI: 10.1016/j.joca.2019.06.011. View

15.

Basedow M, Runciman W, March L, Esterman A . Australians with osteoarthritis; the use of and beliefs about complementary and alternative medicines. Complement Ther Clin Pract. 2014; 20(4):237-42. DOI: 10.1016/j.ctcp.2014.08.002. View

16.

Thorlund J, Juhl C, Roos E, Lohmander L . Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. Br J Sports Med. 2015; 49(19):1229-35. PMC: 4602246. DOI: 10.1136/bjsports-2015-h2747rep. View

17.

Kolasinski S, Neogi T, Hochberg M, Oatis C, Guyatt G, Block J . 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken). 2020; 72(2):149-162. PMC: 11488261. DOI: 10.1002/acr.24131. View

18.

Hinman R, Nelligan R, Bennell K, Delany C . "Sounds a Bit Crazy, But It Was Almost More Personal:" A Qualitative Study of Patient and Clinician Experiences of Physical Therapist-Prescribed Exercise For Knee Osteoarthritis Via Skype. Arthritis Care Res (Hoboken). 2017; 69(12):1834-1844. DOI: 10.1002/acr.23218. View

19.

Buchbinder R, Richards B, Harris I . Knee osteoarthritis and role for surgical intervention: lessons learned from randomized clinical trials and population-based cohorts. Curr Opin Rheumatol. 2014; 26(2):138-44. DOI: 10.1097/BOR.0000000000000022. View

20.

Sakellariou G, Conaghan P, Zhang W, Bijlsma J, Boyesen P, DAgostino M . EULAR recommendations for the use of imaging in the clinical management of peripheral joint osteoarthritis. Ann Rheum Dis. 2017; 76(9):1484-1494. DOI: 10.1136/annrheumdis-2016-210815. View