MonitOring the health trajectory of patients with kNee osteoarthritis referred for orthopaedic opinion: Protocol for the MOTION parallel cohort-implementation study

Christian J. Barton , Michelle Dowsey , Anne Smith , Ilana N. Ackerman , Zanfina Ademi , Samantha Bunzli , Peter Choong , Kay M. Crossley , Joanne Kemp , Jason A. Wallis , Alison Gibbs , Vincent Lengkong , Allison M. Ezzat , Juanita Low , Zhomart Orman , Nicholas F. Taylor , Anna Wong Shee , Natasha A. Lannin , Ewa M. Roos , Raph Hau , Danilo De Oliveira Silva
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Abstract

Objective

This parallel cohort-implementation study, termed MonitOring the health Trajectory of patients with kNee osteoarthritis (MOTION), aims to understand treatment pathways and outcomes for people with knee osteoarthritis referred to Australian public hospitals for orthopaedic assessment (Part A cohort study), and how improving access to first-line care might improve outcomes (Part B implementation study).

Methods and analysis

We will recruit approximately 400 adults with knee osteoarthritis referred for orthopaedic opinion to one of four public hospitals in Victoria, Australia. A subgroup enrolled in the study (n ​= ​109) will receive improved access to community-based first-line care. Outcomes will be evaluated at baseline, 4-, 8-, 12- (primary end point), 24- and 60-months. The primary outcome will divide the cohort into 1's (willing to undergo, waitlisting for, or undergone, TKR surgery) or 0's (not willing to undergo, not undergone, and not waitlisted for, TKR surgery). Secondary outcomes include pain, knee- and health-related quality of life, physical activity participation and health care utilisation. Surgical and health trajectories will be reported descriptively, with factors associated with outcomes explored. The effectiveness of improving access to first-line care will be determined through propensity score methods. The cost-effectiveness of improving access to first-line care will be also be determined, and semi-structured interviews (1:1 and focus groups) involving participants, health professionals, administrators, and research team will inform a comprehensive process evaluation.

Ethics and dissemination

Approved by St Vincent's Hospital Melbourne Human Research Ethics Committee (HREC 251/21). Findings will be disseminated to stakeholders including via conferences, peer-reviewed journals, and social and mainstream media.
监测膝关节骨关节炎患者的健康轨迹以征询骨科意见:MOTION平行队列实施研究方案
本平行队列实施研究,称为监测膝关节骨性关节炎患者的健康轨迹(MOTION),旨在了解转到澳大利亚公立医院进行骨科评估的膝关节骨性关节炎患者的治疗途径和结果(A部分队列研究),以及如何改善一线护理的可及性(B部分实施研究)。方法和分析我们将招募大约400名成年膝关节骨关节炎患者,转到澳大利亚维多利亚州的四家公立医院之一接受骨科意见。纳入研究的一个亚组(n = 109)将获得改善的社区一线护理。结果将在基线、4个月、8个月、12个月(主要终点)、24个月和60个月进行评估。主要结果将队列分为1(愿意接受、等待或接受TKR手术)和0(不愿意接受、未接受、未等待TKR手术)。次要结局包括疼痛、膝关节和健康相关的生活质量、身体活动参与和医疗保健利用。将描述性地报告手术和健康轨迹,并探讨与结果相关的因素。改善获得一线护理的有效性将通过倾向评分方法确定。还将确定改善获得一线护理的成本效益,涉及参与者、卫生专业人员、管理人员和研究小组的半结构化访谈(1:1和焦点小组)将为全面的进程评估提供信息。经墨尔本圣文森特医院人类研究伦理委员会(HREC 251/21)批准。调查结果将通过会议、同行评议期刊以及社会和主流媒体等方式传播给利益攸关方。
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来源期刊
Osteoarthritis and cartilage open
Osteoarthritis and cartilage open Orthopedics, Sports Medicine and Rehabilitation
CiteScore
3.30
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