JMIR Publications

ABSTRACT

Background:

Hip and knee osteoarthritis (OA) are common and lead to pain, stiffness and disability. Clinical practice guidelines (CPG) provide recommendations based on the best available evidence to assist healthcare professionals and patients in clinical decision-making. However, several studies report a gap between guideline recommendations and clinical practice in physiotherapy. Improved implementation strategies and the removal of existing barriers may facilitate the transfer of evidence into clinical practice and contribute to optimised quality of care.

Objective:

The objectives of the research project are 1) to describe the current physiotherapy practice in patients with hip and/or knee OA and to investigate physiotherapists’ adherence to CPGs, 2) to identify and specify barriers and facilitators to guideline use and implementation, 3) to develop and 4) to pilot test a theory-based tailored implementation intervention aiming to increase guideline use in OA care.

Methods:

The research project is divided into four parts: In a first step, we will conduct a nationwide open online survey among German physiotherapists to evaluate the current management of hip and/or knee OA. Subsequently, semi-structured interviews will be conducted to specify barriers and facilitators to guideline use and implementation among physiotherapists. Based on these findings, in part 3 we will develop a theory-driven implementation intervention based on the Theoretical Domains Framework and the Behaviour Change Wheel, which will be evaluated in a controlled pilot study in terms of effectiveness, feasibility and acceptability.

Results:

Data collection of the online survey among German physiotherapists (part 1) was completed in December 2021. The semi-structured interviews (part 2) are expected to be conducted between January and June 2023.

Conclusions:

This research project aims to develop a theory-driven implementation intervention to facilitate the transfer of evidence from hip and knee OA guidelines in physiotherapy practice. We hypothesise that successful implementation will lead to increased guideline adherence in physiotherapists, which in turn will improve the quality of care. The results from our project will provide valuable knowledge concerning the development process and effectiveness of tailored implementation interventions. Clinical Trial: The online survey among physiotherapists (part 1) and the semi-structured interviews (part 2) were registered in the German Clinical Trials Register (DRKS00026702; DRKS00030800).