Implementing good life with osteoArthritis from Denmark (GLA:D®) in australian public hospitals. Part 1: Feasibility

Natalie J Collins; Michelle D Smith; Shaun P O'Leary; Liam R Maclachlan; Michelle A Cottrell; Bill Vicenzino; Viana Vuvan; Tracy Comans; Joanne L Kemp; Christian J Barton; Darryl Lee; Stuart McCaskill; Adrian Cush; Andrew C Hislop; Maree E Raymer

doi:10.1016/j.msksp.2024.102960

Implementing good life with osteoArthritis from Denmark (GLA:D®) in australian public hospitals. Part 1: Feasibility

Musculoskelet Sci Pract. 2024 Apr 16:102960. doi: 10.1016/j.msksp.2024.102960. Online ahead of print.

Authors

Affiliations

¹ School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia. Electronic address: n.collins1@uq.edu.au.
² School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia. Electronic address: m.smith5@uq.edu.au.
³ School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia. Electronic address: s.oleary@uq.edu.au.
⁴ School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Kenneth G Jamieson Department of Neurosurgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. Electronic address: liam.maclachlan@health.qld.gov.au.
⁵ School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia. Electronic address: michelle.cottrell@health.qld.gov.au.
⁶ School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia. Electronic address: b.vicenzino@uq.edu.au.
⁷ School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia. Electronic address: v.vuvan@uq.edu.au.
⁸ Centre for Health Services Research, The University of Queensland, Herston, Queensland, Australia. Electronic address: t.comans@uq.edu.au.
⁹ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia. Electronic address: j.kemp@latrobe.edu.au.
¹⁰ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia; Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia. Electronic address: c.barton@latrobe.edu.au.
¹¹ Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia. Electronic address: djlee889@gmail.com.
¹² Physiotherapy Department, Queen Elizabeth II Hospital, Coopers Plains, Queensland, Australia. Electronic address: Stuart.McCaskill@health.qld.gov.au.
¹³ Physiotherapy Department, Queen Elizabeth II Hospital, Coopers Plains, Queensland, Australia. Electronic address: cush.adrian@gmail.com.
¹⁴ School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Physiotherapy Department, The Prince Charles Hospital, Chermside, Queensland, Australia. Electronic address: Andrew.Hislop@health.qld.gov.au.
¹⁵ Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia. Electronic address: Maree.Raymer@health.qld.gov.au.

PMID: 38670811
DOI: 10.1016/j.msksp.2024.102960

Abstract

Background: Literature reporting positive outcomes from the Good Life with osteoArthritis in Denmark (GLA:D®) program in Australia mainly involves patients attending private physiotherapy services.

Objective: Evaluate the feasibility of implementing GLA:D® in Australian public hospitals.

Design: Implementation study in three metropolitan tertiary public hospitals over six months.

Method: Patients aged ≥18 years with knee or hip joint-related problems deemed appropriate for non-surgical care were invited to participate in GLA:D®. Feasibility was evaluated using RE-AIM framework components (Implementation, Effectiveness, Maintenance) using service-level metrics, patient-level data, and program fidelity assessment. Findings of qualitative interviews with service providers are presented in Part 2.

Results: Implementation: 70 patients (69 with knee osteoarthritis) participated (13 cohorts). 55 (79%) patients attended both education sessions, and 49 patients (70%) attended 10-12 exercises sessions. Fidelity was met based on environmental, therapist, participant- and program-related criteria.

Effectiveness: At 3 months, patients reported lower average pain (visual analogue scale [0-100 mm]: effect size -0.56, 95% CI -0.88 to -0.23) and disability (HOOS/KOOS-12 [100-0]: 0.67, 0.28 to 1.05), and improved quality of life (EQ-5D overall score: 0.46, 0.11 to 0.80). No adverse events were reported. All patients who completed 3-month assessment (n = 52) would recommend GLA:D®. Maintenance: All participating services elected to continue delivering GLA:D® beyond the study.

Conclusions: Implementing GLA:D® in Australian public hospitals is feasible, safe, and acceptable to patients with knee osteoarthritis. Public hospital patients with knee osteoarthritis reported improvements in pain, disability, and quality of life similar to previous GLA:D® cohorts.

Keywords: Education; Exercise; Implementation; Osteoarthritis; Public health.