Department of Health Sciences, Macquarie University, Sydney, New South Wales, Australia
Institute of Bone and Joint Research, The University of Sydney, St Leonards, New South Wales, Australia.
BMJ Open. 2023 Aug 11;13(8):e071045. doi: 10.1136/bmjopen-2022-071045.
This cluster randomised implementation trial will assess the effect of two behavioural change interventions on the proportion of people with structural knee osteoarthritis (OA) referred and attending exercise-based professionals (physiotherapists and exercise physiologists). The interventions are designed to increase awareness of guidelines, benefits and access pathways for exercise therapy. We hypothesise either strategy will result in more people with knee OA being referred and attending physiotherapy/exercise physiology than current standard of care.
We will recruit 30 radiology clinics. 10 clinics will be randomly assigned to each trial arm with 1020 people with knee OA consecutively recruited (102 people per practice) into each arm. Intervention arm 1 is an educational reminder message targeted at primary care practitioners with a hyperlink to national guidelines regarding knee OA clinical management. It will be included in the reporting template of a plain knee X-ray. Intervention arm 2 is the reminder message and a patient-facing infographic explaining the benefits and access pathways for exercise. Both interventions will be delivered once, by the radiology clinics, when a person undergoes plain X-ray for non-traumatic knee pain/dysfunction. The primary outcome is referral to physiotherapist/exercise physiology. The secondary outcome is attendance to that appointment. Both outcomes are self-reported via an online survey administered 4 weeks after the X-ray. Additional survey questions explore facilitators and barriers to appointment attendance and acceptability of the interventions. A subsample of the intervention groups will be recruited for semistructured telephone-based interviews to further explore these latter outcomes.
The study protocol was approved by Macquarie University Human Research Ethics Committee (#520221190343842) and prospectively registered with the Australian New Zealand Clinical Trials Registry. The findings of the trial will be disseminated through peer-reviewed scientific journals and conferences. We will engage with Australian physician colleges and main-stream media to distribute findings.
ACTRN12622001414707p.
本集群随机实施试验将评估两种行为改变干预措施对结构性膝关节骨关节炎（OA）患者就诊和接受基于运动的专业人士（物理治疗师和运动生理学家）的比例的影响。这些干预措施旨在提高对运动治疗指南、益处和途径的认识。我们假设，任何一种策略都会导致更多的膝关节 OA 患者被转诊并接受物理治疗/运动生理学治疗，而不是目前的标准护理。
我们将招募 30 个放射科诊所。将随机分配 10 个诊所到每个试验臂，每个臂连续招募 1020 名膝关节 OA 患者（每个诊所 102 人）。干预臂 1 是针对初级保健从业者的教育提醒信息，带有指向国家膝关节 OA 临床管理指南的超链接。它将包含在普通膝关节 X 光报告模板中。干预臂 2 是提醒信息和面向患者的图表，解释运动的益处和途径。这两种干预措施都将由放射科诊所进行一次，当患者因非创伤性膝关节疼痛/功能障碍接受普通 X 光检查时。主要结局是转介给物理治疗师/运动生理学家。次要结局是预约就诊。这两个结果都是通过在 X 光检查后 4 周进行的在线调查自我报告的。其他调查问题探讨了预约就诊的促进因素和障碍以及干预措施的可接受性。干预组的一个子样本将被招募进行半结构化电话访谈，以进一步探讨这些结果。
研究方案已获得麦考瑞大学人类研究伦理委员会的批准（#520221190343842），并在澳大利亚和新西兰临床试验注册处进行了前瞻性注册。试验结果将通过同行评议的科学期刊和会议传播。我们将与澳大利亚医师学院和主流媒体合作发布研究结果。
ACTRN12622001414707p。
