Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarth
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Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care - the Management of OsteoArthritis In Consultations (MOSAICS) study protocol Krysia S Dziedzic1, Emma L Healey1*, Mark Porcheret1, Bie Nio Ong1, Chris J Main1, Kelvin P Jordan1, Martyn Lewis1, John J Edwards1, Clare Jinks1, Andrew Morden1, Gretl A McHugh2, Sarah Ryan3, Andrew Finney1, Sue Jowett1,4, Raymond Oppong1,4, Ebenezer Afolabi1, Angela Pushpa-Rajah5, June Handy1, Kris Clarkson1, Elizabeth Mason1, Tracy Whitehurst1, Rhian W Hughes1, Peter R Croft1 and Elaine M Hay1
Abstract Background: There is as yet no evidence on the feasibility of implementing recommendations from the National Institute of Health and Care Excellence (NICE) osteoarthritis (OA) guidelines in primary care, or of the effect these recommendations have on the condition. The primary aim of this study is to determine the clinical and cost effectiveness of a model OA consultation (MOAC), implementing the core recommendations from the NICE OA guidelines in primary care. Secondary aims are to investigate the impact, feasibility and acceptability of the MOAC intervention; to develop and evaluate a training package for management of OA by general practitioners (GPs) and practice nurses; test the feasibility of deriving ‘quality markers’ of OA management using a new consultation template and medical record review; and describe the uptake of core NICE OA recommendations in participants aged 45 years and over with joint pain. Design: A mixed methods study with a nested cluster randomised controlled trial. Method: This study was developed according to a defined theoretical framework (the Whole System Informing Self-management Engagement). An overarching model (the Normalisation Process Theory) will be employed to undertake a comprehensive ‘whole-system’ evaluation of the processes and outcomes of implementing the MOAC intervention. The primary outcome is general physical health (Short Form-12 Physical component score [PCS]) (Ware 1996). The impact, acceptability and feasibility of the MOAC intervention at practice level will be assessed by comparing intervention and control practices using a Quality Indicators template and medical record review. Impact and acceptability of the intervention for patients will be assessed via self-completed outcome measures and semi-structured interviews. The impact, acceptability and feasibility of the MOAC intervention and training for GPs and practice nurses will be evaluated using a variety of methods including questionnaires, semi-structured interviews, and observations. (Continued on next page)
* Correspondence: [email protected] 1 Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire ST5 5BG, UK Full list of author information is available at the end of the article © 2014 Dziedzic et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attri
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