Program evaluation of GLA:D® Australia: Physiotherapist training outcomes and effectiveness of implementation for people with knee osteoarthritis

Barton, Christian J; Kemp, Joanne L; Roos, Ewa M.; Skou, Søren Thorgaard; Dundules, K.; Pazzinatto, Marcella Ferraz; Francis, Matthew; Lannin, Natasha A.; Wallis, Jason; Crossley, Kay M

doi:10.1016/j.ocarto.2021.100175

Cited by 39 publications

(74 citation statements)

References 66 publications

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“…Nine in ten medical professionals selected 'trust in the physiotherapist' delivering OA care and 'feedback from patients' as factors that would influence their decision to refer a patient to an OA management programme, confirming themes previously identified in our qualitive study (Wallis et al, 2020). It is possible these enabling Australia reported improvements in their confidence and perceived capacity to deliver education and exercise-therapy (Barton et al, 2021). The evaluation also demonstrated meaningful benefits for participants' pain or quality of life at 12 months follow up, alongside a reduction in the proportion of people with knee OA desiring surgery after completing the programme.…”

Section: Discussionsupporting

confidence: 75%

“…Programme components, including exercise‐therapy, education, and weight loss for those who need it, are recommended as first‐line treatments (NICE, 2014; RACGP, 2018). These treatments improve function, joint confidence and quality of life, and decrease pain and analgesia, without risk of serious adverse events (Barton et al., 2021). Despite improved access to evidence‐based OA care through these programs, over one‐third of patients may receive joint replacement surgery without participating in recommended first‐line management (Cronström et al., 2020; King et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

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A survey of patient and medical professional perspectives on implementing osteoarthritis management programs for hip and knee osteoarthritis

Wallis

Barton

Ackerman

et al. 2022

Musculoskeletal Care

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Background: Strategies are needed to improve referral into, and uptake of, osteoarthritis (OA) management programs. This survey investigated and compared patients' and medical professionals' views around hip and knee OA management and factors impacting implementation of an osteoarthritis management program. Methods:As part of a mixed-methods program of research, patients with hip or knee OA and medical professionals routinely involved in the management of OA, were invited to complete a comprehensive online survey. All data were analysed descriptively or using chi squared tests. Survey findings for factors perceived to impact implementation of an OA management programme were triangulated with previously reported qualitative data.Results: Fifty-three patients (38 females, 15 males) and 32 medical professionals (orthopaedic surgeons, sports physicians, rehabilitation physicians, rheumatologists and general practitioners) completed the survey. Twenty-eight patients (53%) had prior participation in the OA management programme (GLA:D ® ) and 19 medical professionals (59%) had previously referred patients to the programme. Of the participants with prior exposure, 21 patients (75%) and 15 medical professionals (79%) agreed the programme was beneficial. A higher proportion of medical professionals, compared to patients, believed weight loss (100% vs. 67%), injection therapy (50% vs. 21%), hip replacement (100% vs. 62%) and knee replacement (97% vs. 62%) were effective treatments, with no differences for all other treatments. The barriers and enablers identified for referral into, and participation in, an OA management programme mostly aligned to factors identified in previous related qualitative research. Divergent factors in the survey included patients concerns about doing exercise-therapy with 81% (higher than expected) not reporting any concerns about exercising, and 19% (lower than expected) concerned about their OA joint, such as making their pain worse.

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

A survey of patient and medical professional perspectives on implementing osteoarthritis management programs for hip and knee osteoarthritis

Wallis

Barton

Ackerman

et al. 2022

Musculoskeletal Care

Self Cite

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“…Despite multiple attempts to improve engagement with the follow-up survey, including reminder emails and hosting a webinar where survey completion was promoted, the follow-up response rate remained low. This low response rate is consistent with other clinician surveys designed to evaluate physiotherapy professional development initiatives [43] and may be due to lack of time or motivation. To improve response rate, clinicians could be provided with further incentives to complete follow-up surveys, such as prizes, accredited professional development points, or certificates of completion.…”

Section: Strengths and Limitationssupporting

confidence: 85%

A Cancer Exercise Toolkit Developed Using Co-Design: Mixed Methods Study

et al. 2022

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Background Access to exercise therapy for cancer survivors is poor. Professional development to support exercise professionals in delivering these interventions is needed. Few online resources exist for exercise professionals to address this issue. Objective To develop and evaluate a freely available online toolkit to support exercise professionals working with cancer survivors. Methods A 2-phase, experience-based co-design approach was used to develop and evaluate the online toolkit. The two phases were as follows: 1) needs identification and co-design of resources and platform and 2) pilot evaluation. Four co-design workshops were conducted, transcribed, and thematically analyzed to identify key elements for the toolkit. For the pilot evaluation, a customized survey (the Determinants of Implementation Behavior Questionnaire) was distributed to exercise professionals at baseline and 3 months after launch of the online toolkit to determine its usability, utility, and effectiveness in improving their knowledge, confidence, and behavior. Results were reported as the median and interquartile range and changes were calculated using non-parametric tests. Website analytics described site usage after the initial evaluation. Results Twenty-five exercise professionals participated in co-designing 8 key elements of the online Cancer Exercise Toolkit: the homepage and pages for getting started, screening and safety, assessment, exercise prescription, education, locations, and resources. For the pilot evaluation, 277/320 respondents (87% of whom were physiotherapists) from 26 countries completed the survey at baseline, with 58 exercise professionals completing follow-up surveys at 3 months. Exercise professionals’ knowledge, skills, and confidence in delivering exercise therapy to cancer survivors increased 3 months after baseline (items 1, 6, and 8: median score 5, IQR 3 to 6) to follow-up (items 1 and 6: median score 6, IQR 5 to 6; item 8: median score 5, IQR 5 to 7; P<.001) on a 1 to 7 Likert scale. Most participants (35/44, 80%) agreed or strongly agreed they would recommend the toolkit to colleagues. In the 6 months following the pilot evaluation, the toolkit received an average of 866 views per month. Conclusions The co-designed online Cancer Exercise Toolkit was a useful resource for exercise professionals that may increase their knowledge, skills, and confidence in providing exercise therapy to cancer survivors.

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“…Participants with knee osteoarthritis were recruited from within an existing ongoing clinical trial comparing GLA:D® Australia delivered via telehealth or in-person (ACTRN12619000235101). Developed based on international guidelines, GLA:D® is a physiotherapist-led 8 week program [ 3 ], widely implemented in Australia [ 6 ]. It includes two group education sessions that focus on understanding osteoarthritis risk factors, diagnosis, pain management, and self-management strategies, followed by 12 supervised, standardised, yet individualized to each patient, neuromuscular exercise-therapy sessions.…”

Section: Methodsmentioning

confidence: 99%

“…The Good Living with osteoArthritis from Denmark (GLA:D®) program is a guideline-based, physiotherapist-led, standardised but individualized, group education and supervised exercise-therapy program for people with knee and hip osteoarthritis [ 3 ]. It has been implemented globally and delivered to more than 75,000 patients, and has compelling evidence supporting real-world effectiveness related to improvements in pain intensity, functional performance and joint-related quality of life [ 4 , 5 ], and reducing desire for surgery [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“Much better than I thought it was going to be”: Telehealth delivered group-based education and exercise was perceived as acceptable among people with knee osteoarthritis

Ezzat

Bell

Kemp

et al. 2022

Osteoarthritis and Cartilage Open

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Program evaluation of GLA:D® Australia: Physiotherapist training outcomes and effectiveness of implementation for people with knee osteoarthritis

Cited by 39 publications

References 66 publications

A survey of patient and medical professional perspectives on implementing osteoarthritis management programs for hip and knee osteoarthritis

A survey of patient and medical professional perspectives on implementing osteoarthritis management programs for hip and knee osteoarthritis

A Cancer Exercise Toolkit Developed Using Co-Design: Mixed Methods Study

“Much better than I thought it was going to be”: Telehealth delivered group-based education and exercise was perceived as acceptable among people with knee osteoarthritis

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