Osteoarthritis (OA) is a leading cause of disability among Irish adults and the fastest growing health problem in the world, which results in significant mobility limitations, poor quality of life and high occurrence of sick leave. The individual and societal cost is substantial, while the disease burden is increasing due to earlier onset, an ageing population and a prevailing passive ‘wait and replace’ approach to disease management. Best evidence (over 60 RCTs, European and international guidelines) suggests that OA is amenable to prevention and early treatment through exercise. Despite this, we have failed to implement this approach as a first line treatment strategy. Thus, the primary aim of this project is to research the implementation of an evidence-based education and exercise programme for hip and knee OA (Good Life with osteoArthritis from Denmark (GLA:D)) in Ireland. This will be carried out using a participatory health research paradigm involving key stakeholders and end-users. It will (1) ENGAGE clinicians and patients to determine existing implementation barriers to culturally adapt the programme and implementation strategy, (2) IMPLEMENT the evidence-based self-management exercise and education programme by training physiotherapists in the private and public sector, (3) EVALUATE short and long-term implementation indicators and patient outcomes related to pain, function, quality of life and healthcare utilisation. This project will utilise a mixed-methods design, employing quantitative and qualitative approaches in an observational cohort. These outcomes can be used to inform the process of clinical guideline implementation in healthcare settings in Ireland. The group exercise referral strategy will aim to promote self-management, reduce disease burden and orthopaedic inpatient and outpatient waiting times. This research has the potential to change practice and act as a template to promote a policy of exercise and physical activity referral for chronic musculoskeletal disease that utilises community engagement effectively and enacts change ‘together”.
