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Completed

NCT Number: NCT02876120

The STavanger osteoARThritis Study

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.

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Key information

Conditions

Knee Osteoarthritis Arthritis Hip Osteoarthritis Joint Diseases Musculoskeletal Diseases Osteoarthritis Osteoarthritis, Hip Osteoarthritis, Knee Rheumatic Diseases

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Implementation

Other

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.

Primary outcomes

  1. Change in patient-reported quality of osteoarthritis care

    Time frame: 8 weeks pre-implementation vs. 8 weeks post-implementation

    Using the "OsteoArthritis Quality Indicator questionnaire"

Secondary outcomes

  1. Change in the number of PT discharge summaries to the referring GP

    Time frame: 8 weeks pre-implementation vs. 8 weeks post-implementation

  2. Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that has explored non-surgical treatment modalities beforehand

    Time frame: 8 weeks pre-implementation vs. 8 weeks post-implementation

  3. 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

    Time frame: 8 weeks pre-implementation vs. 8 weeks post-implementation

  4. Change in the proportion of people with OA referred to orthopaedic surgeon in secondary care that leads to scheduled joint surgery

    Time frame: 8 weeks pre-implementation vs. 8 weeks post-implementation

Sponsors and collaborators

Lead sponsor

Diakonhjemmet Hospital

Other

Collaborators

  • Helse Stavanger HF
  • Stavanger Municipality

Registry information

Official study title

The STavanger osteoARThritis Study in Primary Health Care

Acronym: START

Important dates

Study start
2016
Primary completion
2017
Study completion
2017
First posted
Aug 23, 2016
Registry last updated
Feb 1, 2018

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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