The STavanger osteoARThritis Study

Knee Osteoarthritis Clinical Trial

— START  

Official title:

The STavanger osteoARThritis Study in Primary Health Care

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02876120
• Other study ID #: 2016/1335
• Status: Completed
• Phase: N/A
• First received: August 15, 2016
• Last updated: January 30, 2018
• Start date: September 2016
• Est. completion date: November 2017

Study information

• Verified date: January 2018
• Source: Diakonhjemmet Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 330
• Est. completion date: November 2017
• Est. primary completion date: November 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

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

Related Conditions & MeSH terms

• Hip Osteoarthritis
• Knee Osteoarthritis
• Osteoarthritis
• Osteoarthritis, Hip
• Osteoarthritis, Knee

Intervention

Other:
• Implementation
Multifaceted implementation strategy to implement evidence based international osteoarthritis treatment recommendations among GPs and PTs in private practice, template for PT discharge reports to GP, patient osteoarthritis education programs, and facilitate multidisciplinary collaboration between the PTs and GPs.

Locations

Country	Name	City	State
n/a

Sponsors (3)

Lead Sponsor	Collaborator
Diakonhjemmet Hospital	Helse Stavanger HF, Stavanger Municipality

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in patient-reported quality of osteoarthritis care	Using the "OsteoArthritis Quality Indicator questionnaire"	8 weeks pre-implementation vs. 8 weeks post-implementation
Secondary	Change in the number of PT discharge summaries to the referring GP		8 weeks pre-implementation vs. 8 weeks post-implementation
Secondary	Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that has explored non-surgical treatment modalities beforehand		8 weeks pre-implementation vs. 8 weeks post-implementation
Secondary	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		8 weeks pre-implementation vs. 8 weeks post-implementation
Secondary	Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that leads to scheduled joint surgery		8 weeks pre-implementation vs. 8 weeks post-implementation