205 Participants Needed

Physiotherapist-Led Care for Osteoarthritis

JM
CM
Overseen ByChad McClintock, MSc
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Jordan Miller, PT, PhD
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 1 JurisdictionThis treatment is already approved in other countries

Trial Summary

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that Physiotherapist-Led Care for Osteoarthritis is an effective treatment?

The available research shows that Physiotherapist-Led Care for Osteoarthritis can be effective in managing knee and hip pain. One study aimed to improve osteoarthritis management by involving both general practitioners and physiotherapists, focusing on providing information, exercise, and weight control before considering surgery. This approach was found to enhance the quality of care. Another study evaluated a new service delivery model for knee osteoarthritis and found it improved health outcomes compared to usual care. These findings suggest that involving physiotherapists in the care process can lead to better management of osteoarthritis symptoms.12345

What safety data exists for physiotherapist-led care for osteoarthritis?

The provided research does not directly address safety data for physiotherapist-led care for osteoarthritis. However, it discusses various models of care, including physiotherapist-led interventions, aimed at improving osteoarthritis management. These studies focus on the effectiveness, acceptability, and implementation of such models, but do not specifically report on safety outcomes. Further research specifically evaluating safety data would be needed to answer this question comprehensively.12467

Is the physiotherapist-led care model a promising treatment for hip and knee pain in osteoarthritis?

Yes, the physiotherapist-led care model is promising because it aims to improve the quality of care by having physiotherapists diagnose and manage treatment plans. This approach can enhance effectiveness and provide better care for patients with hip and knee pain.12389

What is the purpose of this trial?

This is a pilot cluster randomized controlled trial to to evaluate the individual and health system impacts of implementing a new physiotherapist-led primary care model for hip and knee pain in Canada.

Research Team

JM

Jordan Miller, PhD

Principal Investigator

Queen's University

Eligibility Criteria

This trial is for adults over 18 who want to see a primary care provider because of hip or knee pain. They must be able to understand, read, and write English. People with cancer or neurodegenerative diseases causing the pain, or those with post-arthroplasty (joint replacement) pain cannot join.

Inclusion Criteria

I am an adult seeking care for hip or knee pain.

Exclusion Criteria

Cannot understand, read, and write English
My hip or knee pain is caused by my cancer.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Assessment and Screening

Initial assessment and screening by a physiotherapist as the first point of contact

1 week
1 visit (in-person)

Treatment

Participants receive a brief individualized intervention and additional PT care if needed

20 weeks
Multiple visits (in-person and virtual as needed)

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 months
Regular follow-up visits (in-person and virtual)

Treatment Details

Interventions

  • Physiotherapist-led primary care model for hip and knee pain
  • Usual physician-led primary care model for hip and knee pain
Trial Overview The study is testing a new way of treating hip and knee pain where physiotherapists lead the care instead of doctors. It's set up as a pilot test in Canada where groups are randomly chosen to either try this new model or stick with the usual doctor-led approach.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Physiotherapist-led primary care model for hip and knee painExperimental Treatment1 Intervention
The index intervention will incorporate a PT within the primary care team and make them available at the first point of contact for people with hip or knee pain. There will be 4 key components of this intervention: 1) Initial assessment and screening; 2) Brief individualized intervention at first visit; 3) Health services navigation; 4) Providing additional PT care for people with an unmet need (e.g., no insurance coverage for PT).
Group II: Usual physician-led primary care model for hip and knee painActive Control1 Intervention
Participants will be seen by a primary care physician or a nurse practitioner, depending on the current practice at the clinic. Participants in both groups will be permitted to seek additional care outside of the primary care clinic.

Physiotherapist-led primary care model for hip and knee pain is already approved in Canada for the following indications:

🇨🇦
Approved in Canada as Physiotherapist-led primary care model for:
  • Hip pain
  • Knee pain

Find a Clinic Near You

Who Is Running the Clinical Trial?

Jordan Miller, PT, PhD

Lead Sponsor

Trials
4
Recruited
1,800+

Jordan Miller, PT, PhD

Lead Sponsor

Trials
4
Recruited
1,800+

The Arthritis Society, Canada

Collaborator

Trials
27
Recruited
9,700+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials
1,417
Recruited
26,550,000+

Findings from Research

This scoping review aims to identify and analyze models of care (MoCs) specifically designed for patients with knee osteoarthritis (OA) in primary healthcare settings, addressing a significant gap in the implementation of evidence-based interventions.
The review will evaluate the core components and outcomes of these MoCs, which could enhance their transferability to practice and ultimately improve patient care and reduce healthcare costs associated with knee OA.
Models of care for patients with knee osteoarthritis in primary healthcare: a scoping review protocol.Costa, D., Cruz, EB., Rodrigues, AM., et al.[2021]
A new four-step model of care for treating knee pain in older adults was developed, incorporating 27 recommended interventions identified from 77 publications, emphasizing a structured approach in primary care.
The model starts with self-care options like exercise and weight loss, progressing to pharmacological treatments and potentially surgery, ensuring that all older adults with knee pain receive appropriate and evidence-based care.
Treatment of knee pain in older adults in primary care: development of an evidence-based model of care.Porcheret, M., Jordan, K., Croft, P.[2022]
In a randomized controlled trial involving 163 patients, those receiving physiotherapist-led orthopaedic triage reported significantly higher quality of care compared to those receiving standard practice, particularly in areas like examination, treatment information, and caregiver understanding.
Patients in the physiotherapist-led group felt their treatment expectations were better met and showed a greater intention to follow self-management advice, suggesting this model enhances patient-centered care and may improve treatment adherence.
Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial.Samsson, KS., Bernhardsson, S., Larsson, ME.[2018]

References

Models of care for patients with knee osteoarthritis in primary healthcare: a scoping review protocol. [2021]
Treatment of knee pain in older adults in primary care: development of an evidence-based model of care. [2022]
Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial. [2018]
Improving osteoarthritis management in primary healthcare: results from a quasi-experimental study. [2021]
Effectiveness of a New Service Delivery Model for Management of Knee Osteoarthritis in Primary Care: A Cluster Randomized Controlled Trial. [2023]
Advanced Practice Physiotherapists and the implementation of the JIGSAW-E model for the management of osteoarthritis in Scottish primary care settings: a qualitative case study. [2023]
Protocol for the process and feasibility evaluations of a new model of primary care service delivery for managing pain and function in patients with knee osteoarthritis (PARTNER) using a mixed methods approach. [2021]
Primary care-based models of care for osteoarthritis; a scoping review. [2023]
Implementing a structured model for osteoarthritis care in primary healthcare: A stepped-wedge cluster-randomised trial. [2021]
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