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

Implementation Science

Elaine M Hay⁵  Peter R Croft⁵  Rhian W Hughes⁵  Tracy Whitehurst⁵  Elizabeth Mason⁵  Kris Clarkson⁵  June Handy⁵  Angela Pushpa-Rajah²  Ebenezer Afolabi⁵  Raymond Oppong³  Sue Jowett³  Andrew Finney⁵  Sarah Ryan¹  Gretl A McHugh⁴  Andrew Morden⁵  Clare Jinks⁵  John J Edwards⁵  Martyn Lewis⁵  Kelvin P Jordan⁵  Chris J Main⁵  Bie Nio Ong⁵  Mark Porcheret⁵  Emma L Healey⁵  Krysia S Dziedzic⁵ 

[1] The Haywood Hospital, Staffordshire Rheumatology Centre, High Lane, Burslem, Stoke-On-Trent ST6 7AG, Staffordshire, UK;Nottingham Clinical Trials Unit, Nottingham Health Science Partners, C Floor, South Block, Queen¿s Medical Centre, Nottingham NG7 2UH, UK;School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;The School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester M13 9PL, UK;Arthritis Research UK Primary Care Centre, Keele University, Keele ST5 5BG, Staffordshire, UK

关键词: Self-management;    NICE guidelines;    Primary care;    Implementation;    General practice;    Osteoarthritis;   

Others  :  1146609
DOI  :  10.1186/s13012-014-0095-y

 received in 2014-04-17, accepted in 2014-07-08,  发布年份 2014

【 摘 要 】

Background

There is as yet no evidence on the feasibility of implementing recommendations from the National Institute of Health and Care Excellence (NICE) osteoarthritis (OA) guidelines in primary care, or of the effect these recommendations have on the condition. The primary aim of this study is to determine the clinical and cost effectiveness of a model OA consultation (MOAC), implementing the core recommendations from the NICE OA guidelines in primary care. Secondary aims are to investigate the impact, feasibility and acceptability of the MOAC intervention; to develop and evaluate a training package for management of OA by general practitioners (GPs) and practice nurses; test the feasibility of deriving `quality markers¿ of OA management using a new consultation template and medical record review; and describe the uptake of core NICE OA recommendations in participants aged 45 years and over with joint pain.

Design

A mixed methods study with a nested cluster randomised controlled trial.

Method

This study was developed according to a defined theoretical framework (the Whole System Informing Self-management Engagement). An overarching model (the Normalisation Process Theory) will be employed to undertake a comprehensive `whole-system¿ evaluation of the processes and outcomes of implementing the MOAC intervention. The primary outcome is general physical health (Short Form-12 Physical component score [PCS]) (Ware 1996). The impact, acceptability and feasibility of the MOAC intervention at practice level will be assessed by comparing intervention and control practices using a Quality Indicators template and medical record review. Impact and acceptability of the intervention for patients will be assessed via self-completed outcome measures and semi-structured interviews. The impact, acceptability and feasibility of the MOAC intervention and training for GPs and practice nurses will be evaluated using a variety of methods including questionnaires, semi-structured interviews, and observations.

Discussion

The main output from the study will be to determine whether the MOAC intervention is clinically and cost effective. Additional outputs will be the development of the MOAC for patients consulting with joint pain in primary care, training and educational materials, and resources for patients and professionals regarding supported self-management and uptake of NICE guidance.

Trial registration

ISRCTN number: ISRCTN06984617 webcite.

【 授权许可】

   
2014 Dziedzic et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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