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Cottrell MA, Raymer ME, Maclachlan LR, Vuvan V, Smith MD, O'Leary SP, Vicenzino B, Comans T, Kemp JL, Barton CJ, Collins NJ. Implementing good life with osteoArthritis from Denmark (GLA:D®) in Australian public hospitals. Part 2: Service providers' perceptions. Musculoskelet Sci Pract 2024; 71:102961. [PMID: 38664192 DOI: 10.1016/j.msksp.2024.102961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Previous literature has reported the successful implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program into predominantly private practice settings. There may be unique challenges present within the public hospital setting that influence GLA:D® implementation in public health. OBJECTIVE Explore the attitudes and experiences of service providers directly involved in implementing GLA:D® in Australian public tertiary hospitals. DESIGN Qualitative descriptive study design. METHOD Service providers (n = 14) from three participating hospitals took part in semi-structured focus groups at the completion of the 6-month implementation period. Inductive thematic analysis was employed to identify primary domains across all facilities. RESULTS Four broad domains were identified. Factors that influenced uptake included GLA:D® being a recognisable, evidence-based product requiring minimal development or adaptation. The fidelity of the GLA:D® Australia program was challenged by referral of patients with multiple/complex medical comorbidities, and patient preference to complete registry data via paper rather than online. Several operational considerations are required when delivering GLA:D® in a public hospital setting, including adequate numbers of GLA:D®-trained staff, additional screening requirements, obtaining appropriate clinical space, and persisting patient barriers to attending the service. GLA:D® provided benefits beyond improvement in pain and function, including social interactivity, high attendance and promotion of long-term self-management, while also maximising service efficiencies. CONCLUSIONS Implementing GLA:D® in Australian public hospitals was supported by service providers. Specific operational and administrative factors, including staff training, patient complexity, and registry requirements should be considered when attempting to embed and sustain GLA:D® in large Australian public tertiary hospitals.
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Affiliation(s)
- Michelle A Cottrell
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
| | - Maree E Raymer
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
| | - Liam R Maclachlan
- 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.
| | - Viana Vuvan
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Shaun P O'Leary
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia; School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Tracy Comans
- Centre for Health Services Research, The University of Queensland, Herston, Queensland, Australia.
| | - Joanne L Kemp
- 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, Melbourne, Victoria, Australia.
| | - Christian J Barton
- 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, Melbourne, Victoria, Australia; Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Natalie J Collins
- 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.
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Collins NJ, Smith MD, O'Leary SP, Maclachlan LR, Cottrell MA, Vicenzino B, Vuvan V, Comans T, Kemp JL, Barton CJ, Lee D, McCaskill S, Cush A, Hislop AC, Raymer ME. Implementing good life with osteoArthritis from Denmark (GLA:D®) in australian public hospitals. Part 1: Feasibility. Musculoskelet Sci Pract 2024; 71:102960. [PMID: 38670811 DOI: 10.1016/j.msksp.2024.102960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
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.
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Affiliation(s)
- Natalie J Collins
- 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.
| | - Michelle D Smith
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Shaun P O'Leary
- 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.
| | - Liam R Maclachlan
- 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.
| | - Michelle A Cottrell
- 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.
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Viana Vuvan
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia.
| | - Tracy Comans
- Centre for Health Services Research, The University of Queensland, Herston, Queensland, Australia.
| | - Joanne L Kemp
- 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.
| | - Christian J Barton
- 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.
| | - Darryl Lee
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
| | - Stuart McCaskill
- Physiotherapy Department, Queen Elizabeth II Hospital, Coopers Plains, Queensland, Australia.
| | - Adrian Cush
- Physiotherapy Department, Queen Elizabeth II Hospital, Coopers Plains, Queensland, Australia.
| | - Andrew C Hislop
- School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia; Physiotherapy Department, The Prince Charles Hospital, Chermside, Queensland, Australia.
| | - Maree E Raymer
- Department of Physiotherapy, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.
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Cottrell MA, Hill AJ, O'Leary SP, Raymer ME, Russell TG. Clinicians' Perspectives of a Novel Home-Based Multidisciplinary Telehealth Service for Patients with Chronic Spinal Pain. Int J Telerehabil 2018; 10:81-88. [PMID: 30588279 PMCID: PMC6296799 DOI: 10.5195/ijt.2018.6249] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Chronic spinal pain conditions can often be successfully managed by a non-surgical, multidisciplinary approach, however many individuals are unable to access such specialised services within their local community. A possible solution may be the delivery of care via telerehabilitation. This study aimed to evaluate clinicians' perspectives on providing clinical care via telerehabilitation during the early implementation of a novel spinal telerehabilitation service. Eight clinicians' were recruited, completing surveys at four separate time points. Confidence in providing treatment via telerehabilitation significantly improved with time (χ2(3)=16.22, p=0.001). Clinicians became significantly more accepting of telerehabilitation being a time- (χ2(3)=11.237, p=0.011), and cost-effective (χ2(3)=9.466, p=0.024) platform in which they could deliver care. Overall satisfaction was high, with technology becoming easier to use (p=0.026) and ability to establish rapport significantly improved with experience (p=0.043). Understanding clinicians' perspectives throughout the early implementation phase of a new telerehabilitation service is a critical component in determining long-term sustainability.
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Affiliation(s)
- Michelle A Cottrell
- SCHOOL OF HEALTH AND REHABILITATION SCIENCE, UNIVERSITY OF QUEENSLAND, QUEENSLAND, AUSTRALIA.,CENTRE FOR RESEARCH EXCELLENCE IN TELEHEALTH, UNIVERSITY OF QUEENSLAND, QUEENSLAND, AUSTRALIA.,PHYSIOTHERAPY DEPARTMENT, ROYAL BRISBANE & WOMEN'S HOSPITAL, QUEENSLAND, AUSTRALIA
| | - Anne J Hill
- SCHOOL OF HEALTH AND REHABILITATION SCIENCE, UNIVERSITY OF QUEENSLAND, QUEENSLAND, AUSTRALIA.,CENTRE FOR RESEARCH EXCELLENCE IN TELEHEALTH, UNIVERSITY OF QUEENSLAND, QUEENSLAND, AUSTRALIA
| | - Shaun P O'Leary
- SCHOOL OF HEALTH AND REHABILITATION SCIENCE, UNIVERSITY OF QUEENSLAND, QUEENSLAND, AUSTRALIA.,PHYSIOTHERAPY DEPARTMENT, ROYAL BRISBANE & WOMEN'S HOSPITAL, QUEENSLAND, AUSTRALIA.,STATE-WIDE NEUROSURGICAL AND ORTHOPAEDIC PHYSIOTHERAPY SCREENING CLINIC & MULTIDISCIPLINARY SERVICE, METRO NORTH HOSPITAL & HEALTH SERVICE, QUEENSLAND, AUSTRALIA
| | - Maree E Raymer
- STATE-WIDE NEUROSURGICAL AND ORTHOPAEDIC PHYSIOTHERAPY SCREENING CLINIC & MULTIDISCIPLINARY SERVICE, METRO NORTH HOSPITAL & HEALTH SERVICE, QUEENSLAND, AUSTRALIA
| | - Trevor G Russell
- SCHOOL OF HEALTH AND REHABILITATION SCIENCE, UNIVERSITY OF QUEENSLAND, QUEENSLAND, AUSTRALIA.,CENTRE FOR RESEARCH EXCELLENCE IN TELEHEALTH, UNIVERSITY OF QUEENSLAND, QUEENSLAND, AUSTRALIA
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Cottrell MA, Hill AJ, O’Leary SP, Raymer ME, Russell TG. Patients are willing to use telehealth for the multidisciplinary management of chronic musculoskeletal conditions: A cross-sectional survey. J Telemed Telecare 2017; 24:445-452. [DOI: 10.1177/1357633x17706605] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Introduction Access to specialised multidisciplinary healthcare services is difficult for many patients with chronic musculoskeletal conditions. A possible solution could be delivery of care via telehealth. This study aims to identify current barriers in accessing healthcare services, and to determine if telehealth is an acceptable mode of healthcare delivery, from the perspective of patients with chronic musculoskeletal conditions. Methods Surveys were distributed to current patients receiving care within the Neurosurgical and Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service (N/OPSC & MDS) at six facilities throughout Queensland, Australia. The 48-item survey evaluated five key areas including demographics; current barriers to attendance; satisfaction with current management provided by the N/OPSC & MDS; technology access and literacy; and attitudes and preference towards telehealth. Results In total, 85 patients (71%) completed the survey. The majority of patients were satisfied overall with the N/OPSC & MDS, but almost one-quarter of the patients reported ceasing treatment due to difficulty accessing services. Over half of the respondents were willing to use telehealth if it reduced the costs (53%) and time (57%) associated with attending appointments. Patients in paid employment were more likely (65%) to use telehealth if it reduced work absenteeism. Overall, 78% of patients were identified as having appropriate technology access to enable home telehealth. Specifically, 43% of patients would prefer home telehealth over having to travel to attend their appointments. Discussion The majority of N/OPSC & MDS patients are willing to engage in telehealth for the management of their chronic musculoskeletal condition. These findings justify consideration of telehealth as an additional method of service delivery within the existing N/OPSC & MD service.
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Affiliation(s)
- Michelle A Cottrell
- School of Health and Rehabilitation Science, University of Queensland, Queensland, Australia
- Centre for Research Excellence in Telehealth, University of Queensland, Queensland, Australia
- Physiotherapy Department, Ipswich Hospital, Queensland, Australia
| | - Anne J Hill
- School of Health and Rehabilitation Science, University of Queensland, Queensland, Australia
- Centre for Research Excellence in Telehealth, University of Queensland, Queensland, Australia
| | - Shaun P O’Leary
- School of Health and Rehabilitation Science, University of Queensland, Queensland, Australia
- Physiotherapy Department, Royal Brisbane & Women’s Hospital, Queensland, Australia
- State-wide Neurosurgical and Orthopaedic Physiotherapy Screening Clinic & Multidisciplinary Service, Metro North Hospital & Health Service, Queensland, Australia
| | - Maree E Raymer
- Physiotherapy Department, Royal Brisbane & Women’s Hospital, Queensland, Australia
- State-wide Neurosurgical and Orthopaedic Physiotherapy Screening Clinic & Multidisciplinary Service, Metro North Hospital & Health Service, Queensland, Australia
| | - Trevor G Russell
- School of Health and Rehabilitation Science, University of Queensland, Queensland, Australia
- Centre for Research Excellence in Telehealth, University of Queensland, Queensland, Australia
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