Gibbs, A.* (1,2); Taylor, N. (1,3); Roddy, L. (3); Durant, K. (2); Fong, C. (3); Hau, R. (3); deVos, L. (2); Barton, C. (1); and Wallis, J. (1,3)
(1) La Trobe University; (2) Access Health and Community; (3) Eastern Health
Aim: Osteoarthritis Hip and Knee Services (OAHKS) clinics substitute an orthopaedic consultant with an advanced musculoskeletal physiotherapist to assess patients with hip and knee osteoarthritis referred to tertiary care. This study explored the feasibility of implementing a community-based OAHKS, comparing results with a hospital-based OAHKS.
Methods: The domains of feasibility explored were acceptability (patient, general practitioner and orthopaedic surgeon), demand (referrals, waiting times) efficacy potential (management decision, conversion-to-surgery rates) and practicality (number and type of discussions between advanced musculoskeletal physiotherapist and doctors, adverse events). Results from a community-based OAHKS were compared with hospital-based OAHKS over a 9-month period in the same metropolitan health region.
Results: 91 eligible patients attended an OAHKS clinic (40 community-based, 51 hospital based). Both the community-based and hospital-based OAHKS had high patient and general practitioner (GP) satisfaction, with small differences in favour of community OAHKS. Waiting times were significantly shorter in the community-based OAHKS (P<0.001) for both initial appointment [community-based OAHKS mean 17 days (SD11), hospital-based OAHKS mean 155 days (SD38)] and commencing non-surgical management [community-based OAHKS mean 32 days (SD22), hospital-based OAHKS mean 67 days (SD32)]. Referral rate to orthopaedics was substantially lower from community-based OAHKS (3%) compared with hospital-based OAHKS (33%) [odds ratio 0.05 (95% CI 0.01-0.41)]. There were no adverse events.
Conclusion: Community-based OAHKS is feasible, acceptable to patients and GPs, and in this study reduced waiting times and surgical referral rates. Future research could investigate whether community-based OAHKS can impact on referral rates and hospital waiting times for surgical opinion.
[pdf-embedder url=”https://opus-tjr.org.au/wp-content/uploads/2019/04/Gibbs-A_poster.pdf” title=”Gibbs A_poster”]
For more information about this abstract, please contact:
Ali Gibbs, La Trobe University and Access Health and Community
- OPUS Forum 2019 Poster Presentations
- The combined effect of physiotherapy, intra-articular steroid injection and bracing on knee OA
- Telehealth v face-to-face physiotherapy for knee OA: a contingent valuation preference exercise
- Effectiveness of behavioural interventions on physical activity levels after joint replacement
- Opioid use prior to elective surgery is strongly associated with persistent use following surgery. An analysis of 14,354 Medicare patients
- Design of a text message intervention to support home exercise for people with knee osteoarthritis
- Candidacy and the Pathway to Total Knee Replacement: A Qualitative Study
- Community Osteoarthritis Hip and Knee Services may be a solution to keeping patients out of hospital
- Are illness perceptions a barrier to uptake of evidence-based interventions for knee osteoarthritis?
- How do patients appraise satisfaction, and pain and function outcomes after total knee replacement?
- Quality of Life Trajectories in Total Knee Replacement Patients: What can they tell us?
- Engaging in an evidence-based osteoarthritis management program: Referrer and patient perspectives
- Implementing evidence based education and exercise for knee osteoarthritis
- Does adding hip to quadriceps exercises improve outcomes for people with knee osteoarthritis?
- The utilisation of total knee replacement exceeds that predicted by population growth and obesity