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

Christian J. Barton; Joanne L. Kemp; Ewa M. Roos; Soren T. Skou; Karen Dundules; Marcella F. Pazzinatto; Matthew Francis; Natasha A. Lannin; Jason A. Wallis; Kay M. Crossley

Osteoarthritis and Cartilage Open (Sep 2021)

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

Christian J. Barton,
Joanne L. Kemp,
Ewa M. Roos,
Soren T. Skou,
Karen Dundules,
Marcella F. Pazzinatto,
Matthew Francis,
Natasha A. Lannin,
Jason A. Wallis,
Kay M. Crossley

Affiliations

Christian J. Barton: Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Department of Surgery, St Vincent's Hospital, University of Melbourne, Australia; Corresponding author. Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia.
Joanne L. Kemp: Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
Ewa M. Roos: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
Soren T. Skou: Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
Karen Dundules: Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
Marcella F. Pazzinatto: Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Laboratory of Biomechanics and Motor Control, School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
Matthew Francis: Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
Natasha A. Lannin: Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia; Alfred Health, Melbourne, Australia
Jason A. Wallis: Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Australia
Kay M. Crossley: Department of Physiotherapy Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia

Journal volume & issue: Vol. 3, no. 3
p. 100175

Abstract

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Objective: Evaluate the implementation of Good Life with osteoArthritis from Denmark (GLA:D®) for knee osteoarthritis in Australia using the RE-AIM QuEST (Reach, Effectiveness, Adoption, Implementation, Maintenance Qualitative Evaluation for Systematic Translation) framework. Design: Physiotherapists completed surveys before and after GLA:D® training (2017–2020) to assess practices, and barriers and enablers to implementation. Patients completed online baseline, 3-month (post-treatment) and 12-month patient reported outcomes. Effective implementation was defined as within-participant moderate effect size (ES, ≥0.50) for average pain (100 mm VAS) and Knee Injury and Osteoarthritis Outcome Score quality of life scores (KOOS-QoL), and small effect size (≥0.20) for health-related quality of life (EQ-5D-5L). Results: Reach: 1064 physiotherapists and 1945 patients from all states and territories participated. Key barriers included out-of-pocket cost to patients, and program suitability for culturally and linguistically diverse communities. Effectiveness: Following training, more physiotherapists reported discussing treatment goals and weight management, and prescribing supervised, neuromuscular exercise. Patient outcomes at 3- and 12-months (n = 1044 [54%] and 927 [48%]) reflected effective implementation, including reduced pain (ES, 95%CI = 0.72, 0.62–0.84; and 0.65, 0.54–0.77) and improved KOOS-QoL (0.79, 0.69–0.90; and 0.93, 0.81–1.04) and EQ-5D-5L (0.43, 0.31–0.54; and 0.46, 0.35–0.58) scores. Adoption: 297 sites (264 private, 33 public) implemented GLA:D®. Implementation: Most patients completed at least one education (90%), and 10 exercise-therapy (78%) sessions. Adequate staffing to support program delivery was a key enabler. Maintenance: 99% of sites (293/297) continued offering the program in July 2020. Conclusion: Training changed practice and was associated with effective widespread implementation of GLA:D® in Australia.

Published in Osteoarthritis and Cartilage Open

ISSN: 2665-9131 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/osteoarthritis-and-cartilage-open/

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