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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

Dziedzic, Krysia S; Healey, Emma L; Porcheret, Mark; Nio Ong, Bie; Main, Chris J; Jordan, Kelvin P; Lewis, Martyn; Edwards, John J; Jinks, Clare; Morden, Andrew; McHugh, Gretl A; Ryan, Sarah; Finney, Andrew; Jowett, Sue; Oppong, Raymond; Afolabi, Ebenezer; Pushpa-Rajah, Angela; Handy, June; Clarkson, Kris; Mason, Elizabeth; Whitehurst, Tracy; Hughes, Rhian W; Croft, Peter R; Hay, Elaine M

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 Thumbnail


Authors

Mark Porcheret

Bie Nio Ong

Chris J Main

Martyn Lewis

John J Edwards

Andrew Morden

Gretl A McHugh

Sarah Ryan

Sue Jowett

Raymond Oppong

Ebenezer Afolabi

Angela Pushpa-Rajah

June Handy

Kris Clarkson

Elizabeth Mason

Tracy Whitehurst

Rhian W Hughes

Peter R Croft



Abstract

Backgroundhere 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 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.DesignA mixed methods study with a nested cluster randomised controlled trial.MethodThis 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.DiscussionThe 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 RegistrationISRCTN number: ISRCTN06984617.

Citation

Dziedzic, K. S., Healey, E. L., Porcheret, M., Nio Ong, B., Main, C. J., Jordan, K. P., …Hay, E. M. (2014). 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, 9, Article 95. https://doi.org/10.1186/s13012-014-0095-y

Journal Article Type Article
Acceptance Date Jul 8, 2014
Publication Date Aug 27, 2014
Journal Implementation Science
Electronic ISSN 1748-5908
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 9
Article Number 95
DOI https://doi.org/10.1186/s13012-014-0095-y
Keywords Osteoarthritis, General practice, Implementation, Primary care, NICE guidelines, Self-management.

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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..pdf (882 Kb)
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Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/




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