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 the treatment, i.e. whether the treatment was more in line with treatment recommendations
- that GPs referred several patients to physiotherapists
- that the physiotherapists sent several epicrisis to the referring doctor
- better health outcomes for patients
- reduction of the proportion of "unnecessary" referrals to an orthopedist where the first-line treatment has not been tried first
- reduction of referrals to MRI for assessment of osteoarthritis
- higher patient satisfaction with the 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 CAN JOIN?
Recruitment has ended.
Included patients were adults in need of treatment due to osteoarthritis of the hip or knee.
WHAT DOES THE STUDY INCLUDE?
The model was implemented in six municipalities in Upper Romerike. A summary of international treatment recommendations and the SAMBA model was presented to GPs and physiotherapists at a joint professional meeting. An orthopedist was also present at the meeting and discussed when it is appropriate to refer for assessment by an orthopedist. The physiotherapists also participated in a full-day course organized by "Active with osteoarthritis (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 training for patients with hip and knee osteoarthritis.
The SAMBA model meant that the GP gave patients with hip and knee osteoarthritis information about treatment options for osteoarthritis, prescribed prescriptions for pain-relieving or anti-inflammatory drugs if necessary and referred them to a physiotherapist. The physiotherapists arranged a group-based arthrosis course followed by a guided exercise follow-up of 8-12 weeks. After the end of the training period, the patient and the GP discussed the effect of the treatment. Together they assessed whether the patient could continue training on his own, needed a new referral to physiotherapy or whether the osteoarthritis had worsened and it was appropriate to refer to an orthopedist for assessment of surgery.
The SAMBA study was a collaboration between six municipalities in Upper Romerike (Eidsvoll, Gjerdrum, Hurdal, Nannestad, Nes and Ullensaker), the Orthopedic Clinic at Akershus University Hospital and the research environments at the National Competence Service for Rheumatology Rehabilitation at Diakonhjemmet Hospital and the Department of General Medicine at the University of Oslo.