There is no cure for osteoarthritis and the latest treatment recommendations provide strong advice on self-management programs, education, exercise and weight management as basic treatment for all osteoarthritis patients. The treatment recommendations emphasize the importance of the patient being well informed about surgical and non-surgical treatment options, and their advantages and disadvantages, so that the patient and specialist can make a shared decision-making about the further course of treatment. There is therefore a need to develop a tool that can provide patients with individualized information on all relevant treatment options.
In this project, we will develop an 8-week digital information and training intervention that patients referred for assessment in the specialist health service will have access to in the period from referral to consultation. Our hypothesis is that such an intervention will ensure that patients have knowledge and experience of the various treatment recommendations before they come to a consultation in the specialist health service, and that it will improve communication and co-selection of further treatment during the consultation. The intervention will be tested in a randomized controlled trial.
Furthermore, we will investigate whether we can use patient self-reporting to triage patients for job-shifting, where patients most likely to be eligible for surgery are referred for consultation with an orthopedic surgeon, while patients most likely to be eligible for exercise instead of surgery are referred for consultation with a physiotherapist.
Patients with knee osteoarthritis referred for assessment by the specialist health service (Diakonhjemmet Hospital) are eligible for the study.
Recruitment of participants for the study has not yet started.
This project consists of two sub-studies:
Patients will complete patient-reported data before being randomly allocated to one of two groups: One group (the intervention group) will have access to an 8-week digital information and exercise intervention through the Youwell app in the time between referral and consultation in the specialist health service. They will also self-report their health status every two weeks so that the practitioner can see how the condition develops over time instead of only getting a snapshot in connection with the consultation.The other group (the control group) will follow the current practice, i.e. they will not receive any offer from the specialist health service in the period between referral and consultation. The main outcome measure will be the patients' knowledge of treatment recommendations for knee osteoarthritis. We will also investigate the degree of co-selection and satisfaction with the treatment.
Information from sub-study A will be used to develop a job-shifting algorithm based on patient self-report. Patients most likely to undergo surgery will be triaged to a consultation with an orthopaedic surgeon, while patients most likely to be recommended exercise will be triaged to a consultation with a physiotherapist. This algorithm will be tested in a feasibility study. The main outcome measure will be the proportion of patients triaged to the right practitioner, as well as patient satisfaction with treatment.