In the UK osteoarthritis (OA) is primarily managed in primary care and there is evidence that older adults with OA are more likely to receive pharmacological treatments than non-pharmacological treatments for their joint pain. The National Institute of Health and Care Excellence (NICE) and EULAR recommend that core non-pharmacological treatments such as written information and advice on exercises and physical activity should be offered to all people with symptomatic OA. This represents quality care for people with OA. However, general practitioners and practice nurses have difficulties in integrating evidence based practice for OA in their consultations and core approaches are underutilized.
Over the past six years the Institute of Primary Care and Health Sciences, Keele University has been undertaking an NIHR funded study, Managing Osteoarthritis in Consultations (MOSAICS).
A number of barriers were identified such as: lack of time, resources and expertise; believing that OA is an inevitable part of aging; and uncertainty about giving core interventions. Using a complex intervention (a model OA consultation) developed for the MOSAICS study, with patient information (OA guidebook), training and practice nurse clinics we overcame a number of barriers.This presentation will describe the barriers and facilitators in the MOSAICS study and will also map them to findings from a recent systematic review addressing the evidence to practice gap for complex interventions in primary care (2).
Dziedzic KS, Healey EL, Porcheret M, et al. Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care - the Management of Osteoarthritis In Consultations (MOSAICS) study protocol. Implement Sci. 2014 Aug 27;9(1):95.
Lau R, Stevenson F, Ong BN, et al. Addressing the evidence to practice gap for complex interventions in primary care: a systematic review of reviews protocol. BMJ Open. 2014 Jun 23;4(6):e005548.
Disclosure of Interest K. Dziedzic Grant/research support from: National Institute of Health Research