Osteoarthritis (OA) affects 12% of the population and will increase with increased life-expectancy and obesity prevalence. Guidelines recommend that OA should predominantly be managed in primary care and comprise non-pharmacological interventions (education/self-management, exercise and weight loss), followed by drug therapy. Implementation of guidelines has not translated well into practice internationally. A Model of Care (MoC) is an evidence-informed framework that outlines the optimal manner in which condition-specific care should be delivered to consumers. A MoC for OA relevant to of service users’ and providers’ needs, which aligns with SlainteCare objectives is required in Ireland. This research, to be conducted in three phases, aims to determine current primary care management of OA in Ireland, and to develop a MoC focussing on core interventions (education, exercise and weight loss).
Phase 1-Identifing current management of OA. a) A scoping review will establish evidence for MoCs in OA internationally.
b) Qualitative interviews with general practitioners (GPs), primary care staff and service users willl determine current management of OA in Ireland.
c) Utilisation of drugs for OA over 6 years will be investigated by analysing data from the Irish Longitudinal Study of Aging study.
Phase 2-Development of the primary care MoC for OA. The research team will develop a MoC by triangulating Phase 1 findings, underpinned by behaviour change frameworks (e.g. Theoretical Domains Framework) and stakeholder collaboration. The affordability, practicabilty, effectiveness, acceptability, side-effects/safety and equity (APEASE) criteria will be used to ensure it can be realistically delivered.
Phase 3–Testing MoC Acceptability. This phase involves training GPs (and other relevant staff) in the MoC at three practices. They will deliver the MoC to patients with OA, with 3-month recruitment. Qualitative interviews with servicer users and service providers involved in this phase will ascertain its acceptability. The research team will refine the MoC through stakeholder meetings.
