Allison M Ezzat, Joanne L Kemp, Joshua J Heerey, Marcella F Pazzinatto, Danilo De Oliveira Silva, Karen Dundules, Matthew Francis, Christian J Barton
{"title":"通过澳大利亚远程医疗在丹麦实施骨关节炎的美好生活（GLA:D®）项目：一种混合方法的项目评估。","authors":"Allison M Ezzat, Joanne L Kemp, Joshua J Heerey, Marcella F Pazzinatto, Danilo De Oliveira Silva, Karen Dundules, Matthew Francis, Christian J Barton","doi":"10.1177/1357633X231167620","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate the implementation of the Good Life with osteoArthritis in Denmark (GLA:D<sup>®</sup>) program via telehealth in Australia using Reach, Effectiveness, Adoption, Implementation, and Maintenance Qualitative Evaluation for Systematic Translation framework.</p><p><strong>Methods: </strong>Using a convergent mixed-methods design, semi-structured one-on-one interviews with physiotherapist adopters and nonadopters of GLA:D<sup>®</sup> via telehealth were analyzed thematically alongside the examination of registry data (1 March 2020-10 February 2022) from patients with hip or knee osteoarthritis completing GLA:D<sup>®</sup> via telehealth (telehealth-only) or combined with in-person care (hybrid). Effectiveness was determined as changes from baseline to 3-month follow-up (mean differences, 95% confidence intervals, effect size) for Knee injury and Osteoarthritis Outcome Score (KOOS-12)/Hip disability and Osteoarthritis Outcome Score-12 (HOOS-12), and chair stand test. Group- and individual-level changes were compared to published minimally clinically important change scores.</p><p><strong>Results: </strong>Twenty-three interviews (12 adopters, 11 nonadopters) found key barriers/facilitators to reach and adoption, high perceived effectiveness, and strategies to support sustainability. Of 2612 registered patients, 85 (3%) and 115 (4%) completed GLA:D<sup>®</sup> via telehealth-only or hybrid model, respectively. Most effectiveness outcomes were associated with moderate-large improvements. Group-level changes exceeded minimally clinically important change values for KOOS/HOOS-quality of life and chair stand test. Nearly two out of three patients reached a minimally clinically important change for KOOS/HOOS-quality of life. With telehealth-only and hybrid delivery, 99% (<i>n</i> = 82) and 85% (<i>n</i> = 97) were satisfied/very satisfied. Physiotherapist adoption was limited (<i>n</i> = 128, 6%).</p><p><strong>Discussion: </strong>GLA:D<sup>®</sup> delivered via telehealth is effective, had high patient satisfaction, and was perceived positively by physiotherapist adopters. Addressing low reach and adoption requires further implementation strategies to facilitate greater telehealth opportunities for patients and physiotherapists.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"104-120"},"PeriodicalIF":3.5000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Implementation of the Good Life with osteoArthritis in Denmark (GLA:D<sup>®</sup>) program via telehealth in Australia: A mixed-methods program evaluation.\",\"authors\":\"Allison M Ezzat, Joanne L Kemp, Joshua J Heerey, Marcella F Pazzinatto, Danilo De Oliveira Silva, Karen Dundules, Matthew Francis, Christian J Barton\",\"doi\":\"10.1177/1357633X231167620\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>We aimed to evaluate the implementation of the Good Life with osteoArthritis in Denmark (GLA:D<sup>®</sup>) program via telehealth in Australia using Reach, Effectiveness, Adoption, Implementation, and Maintenance Qualitative Evaluation for Systematic Translation framework.</p><p><strong>Methods: </strong>Using a convergent mixed-methods design, semi-structured one-on-one interviews with physiotherapist adopters and nonadopters of GLA:D<sup>®</sup> via telehealth were analyzed thematically alongside the examination of registry data (1 March 2020-10 February 2022) from patients with hip or knee osteoarthritis completing GLA:D<sup>®</sup> via telehealth (telehealth-only) or combined with in-person care (hybrid). Effectiveness was determined as changes from baseline to 3-month follow-up (mean differences, 95% confidence intervals, effect size) for Knee injury and Osteoarthritis Outcome Score (KOOS-12)/Hip disability and Osteoarthritis Outcome Score-12 (HOOS-12), and chair stand test. Group- and individual-level changes were compared to published minimally clinically important change scores.</p><p><strong>Results: </strong>Twenty-three interviews (12 adopters, 11 nonadopters) found key barriers/facilitators to reach and adoption, high perceived effectiveness, and strategies to support sustainability. Of 2612 registered patients, 85 (3%) and 115 (4%) completed GLA:D<sup>®</sup> via telehealth-only or hybrid model, respectively. Most effectiveness outcomes were associated with moderate-large improvements. Group-level changes exceeded minimally clinically important change values for KOOS/HOOS-quality of life and chair stand test. Nearly two out of three patients reached a minimally clinically important change for KOOS/HOOS-quality of life. With telehealth-only and hybrid delivery, 99% (<i>n</i> = 82) and 85% (<i>n</i> = 97) were satisfied/very satisfied. Physiotherapist adoption was limited (<i>n</i> = 128, 6%).</p><p><strong>Discussion: </strong>GLA:D<sup>®</sup> delivered via telehealth is effective, had high patient satisfaction, and was perceived positively by physiotherapist adopters. Addressing low reach and adoption requires further implementation strategies to facilitate greater telehealth opportunities for patients and physiotherapists.</p>\",\"PeriodicalId\":50024,\"journal\":{\"name\":\"Journal of Telemedicine and Telecare\",\"volume\":\" \",\"pages\":\"104-120\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Telemedicine and Telecare\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/1357633X231167620\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/4/20 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Telemedicine and Telecare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/1357633X231167620","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/20 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program via telehealth in Australia: A mixed-methods program evaluation.
Introduction: We aimed to evaluate the implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program via telehealth in Australia using Reach, Effectiveness, Adoption, Implementation, and Maintenance Qualitative Evaluation for Systematic Translation framework.
Methods: Using a convergent mixed-methods design, semi-structured one-on-one interviews with physiotherapist adopters and nonadopters of GLA:D® via telehealth were analyzed thematically alongside the examination of registry data (1 March 2020-10 February 2022) from patients with hip or knee osteoarthritis completing GLA:D® via telehealth (telehealth-only) or combined with in-person care (hybrid). Effectiveness was determined as changes from baseline to 3-month follow-up (mean differences, 95% confidence intervals, effect size) for Knee injury and Osteoarthritis Outcome Score (KOOS-12)/Hip disability and Osteoarthritis Outcome Score-12 (HOOS-12), and chair stand test. Group- and individual-level changes were compared to published minimally clinically important change scores.
Results: Twenty-three interviews (12 adopters, 11 nonadopters) found key barriers/facilitators to reach and adoption, high perceived effectiveness, and strategies to support sustainability. Of 2612 registered patients, 85 (3%) and 115 (4%) completed GLA:D® via telehealth-only or hybrid model, respectively. Most effectiveness outcomes were associated with moderate-large improvements. Group-level changes exceeded minimally clinically important change values for KOOS/HOOS-quality of life and chair stand test. Nearly two out of three patients reached a minimally clinically important change for KOOS/HOOS-quality of life. With telehealth-only and hybrid delivery, 99% (n = 82) and 85% (n = 97) were satisfied/very satisfied. Physiotherapist adoption was limited (n = 128, 6%).
Discussion: GLA:D® delivered via telehealth is effective, had high patient satisfaction, and was perceived positively by physiotherapist adopters. Addressing low reach and adoption requires further implementation strategies to facilitate greater telehealth opportunities for patients and physiotherapists.
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Journal of Telemedicine and Telecare provides excellent peer reviewed coverage of developments in telemedicine and e-health and is now widely recognised as the leading journal in its field. Contributions from around the world provide a unique perspective on how different countries and health systems are using new technology in health care. Sections within the journal include technology updates, editorials, original articles, research tutorials, educational material, review articles and reports from various telemedicine organisations. A subscription to this journal will help you to stay up-to-date in this fast moving and growing area of medicine.
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