SAMBA
Collaboration for better osteoarthritis treatment
Project manager
PhD fellow
ABOUT THE PROJECT
The SAMBA study aimed to investigate whether the introduction of a new, evidence-based treatment model in the municipal health service for people with hip and knee osteoarthritis led to:
- better quality of treatment, i.e. whether the treatment was more in line with treatment recommendations
- that GPs referred more patients to physiotherapists
- that the physiotherapists sent several case reports to the referring doctor
- better health outcomes for patients
- reduction in the proportion of "unnecessary" referrals to orthopedists where first-line treatment has not been tried first
- reduction of referrals to MRI for the assessment of osteoarthritis
- higher patient satisfaction with treatment
- changes in health-related lifestyle such as being physically active in line with recommendations on physical activity and having a healthy body weight
WHO COULD BE WITH?
Recruitment has ended.
Included patients were adults in need of treatment due to osteoarthritis of the hip or knee.
WHAT DOES THE STUDY INVOLVE?
The model was implemented in six municipalities in Øvre Romerike. A summary of international treatment recommendations and the SAMBA model were presented to GPs and physiotherapists at a joint professional meeting. An orthopedist also attended the meeting and discussed when it is appropriate to refer for assessment to an orthopedist. The physiotherapists also participated in a full-day course under the auspices of "Aktiv med artrose (AktivA)" where the treatment recommendations were elaborated on and they were given ready-made material to be able to hold group-based osteoarthritis courses and guided exercise for patients with hip and knee osteoarthritis.
The SAMBA model involved the GP providing patients with hip and knee osteoarthritis with information about treatment options for osteoarthritis, prescribing prescriptions for painkillers or anti-inflammatory drugs if necessary, and referring them to a physiotherapist. The physiotherapists arranged a group-based osteoarthritis course followed by a guided exercise follow-up of 8-12 weeks. After the exercise period, the patient and the GP discussed the effect of the treatment. Together, they assessed whether the patient could continue exercising on their own, needed a new referral to physiotherapy, or whether the osteoarthritis had worsened and it was appropriate to refer them to an orthopaedic surgeon for assessment of surgery.
The SAMBA study was a collaboration between six municipalities in Øvre Romerike (Eidsvoll, Gjerdrum, Hurdal, Nannestad, Nes and Ullensaker), the Orthopaedic Clinic at Akershus University Hospital and the research groups at the National Competence Service for Rheumatological Rehabilitation at Diakonhjemmet Hospital and the Department of General Medicine at the University of Oslo.
LINKS TO PUBLICATIONS:
Protocol article: https://pubmed.ncbi.nlm.nih.gov/26631224/
Main results: https://pubmed.ncbi.nlm.nih.gov/31613885/
Secondary analyses: https://pubmed.ncbi.nlm.nih.gov/32284049/
Compliance: https://pubmed.ncbi.nlm.nih.gov/31075423/