scholarly journals Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals Trial (CONNACT) – A Feasibility Study in patients with knee osteoarthritis using a mixed method approach

2020 ◽  
Author(s):  
Bryan Tan ◽  
Benjamin Tze Keong DING ◽  
Michelle Jessica PEREIRA ◽  
Soren Thorgaard SKOU ◽  
Julian THUMBOO ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Mixed Method ◽  
Randomized Control Trial ◽  
Outcome Measure ◽  
Model Of Care ◽  
Structured Interviews ◽  
Randomized Control ◽  
Method Approach

Abstract Background Osteoarthritis is a leading cause of global disability resulting in significant morbidity and cost to the healthcare system. Current guidelines recommend lifestyle changes such exercises and weight loss as first line treatment prior to surgical consideration. Our current model of care is inefficient with suboptimal allied health intervention for effective behaviour changes. A 12-week community based, individualized, multidisciplinary new model of care for knee osteoarthritis was developed in light of current deficiencies. Methods The primary aim of this study was to determine the feasibility of a full randomized controlled trial evaluating this new model of care using pre-defined progression criteria. The secondary aim was to optimize the intervention and study design through a process evaluation. A pilot randomized trial design using a mixed method approach was utilized. Progression criteria for a full trial including key domains of patient recruitment and retention, outcome measure acceptability and improvement, adverse events were developed. The primary outcome measure was the Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline and 12-weeks. Secondary outcomes included quality of life, functional and psychological assessments. Semi-structured interviews were conducted with the patients at 12-weeks. Results 20 patients (3 males, 17 females) were randomized (10 intervention, 10 control). Intervention arm patients reported better improvements in their knee function, quality of life, psychological outcome, dietary improvement and weight loss compared to the control arm at 12-weeks. Semi-structured interviews revealed several themes pertaining to feasibility and intervention optimization. 5 out of the 6 progression criteria’s domains were met. Conclusion This pilot has demonstrated the feasibility of a full randomized control trial investigating the potential effectiveness of the new proposed model of care for knee osteoarthritis using pre-defined progression criteria and process evaluation. Results from the qualitative study were used to modify and improve the intervention content, delivery model and study design for a large effectiveness-implementation hybrid randomized control trial that is currently underway.

scholarly journals Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals in Knee Osteoarthritis (CONNACT): Study Protocol for an Effectiveness-Implementation Hybrid Randomized Control Trial

2020 ◽  
Author(s):  
Bryan Yijia Tan ◽  
Michelle Jessica PEREIRA ◽  
Yang Su-Yin ◽  
David J. Hunter ◽  
Soren Thorgaard SKOU ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Mixed Method ◽  
Randomized Control Trial ◽  
Healthcare Professionals ◽  
Model Of Care ◽  
Knee Oa ◽  
Randomized Control ◽  
The Cost ◽  
Method Approach

Abstract Background: Knee Osteoarthritis (OA) is a leading cause of global disability, with most patients not receiving optimal non-surgical treatment resulting in significant morbidity and cost to the healthcare system, The Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals (CONNACT) Model of Care (MoC) was developed by optimizing evidence-based non-surgical treatments to deliver value-based care for people with knee OA. The primary aim of this study is to determine the clinical effectiveness of the CONNACT MoC compared to usual care. The secondary aims are: a) To determine the cost-effectiveness and b) To develop an evaluation and implementation framework to inform large scale implementation for this MoC. Design: A Type 1 Effectiveness-Implementation Hybrid Trial using an explanatory sequential mixed-method approach. Methodology: The study consists of 3 components. The first component is the pragmatic, parallel-arm, single-blinded randomized control trial. Inclusion criteria are patients with knee OA based on the National Institute of Health and Care Excellence (NICE) criteria with radiographic severity of greater than Kellgren-Lawrence 1, and Knee Injury and OA Outcome Score (KOOS4) of equal or less than 75. Exclusion criteria include other forms of arthritis, history of previous knee arthroplasty or wheelchair-bound patient. The intervention arm will undergo the CONNACT MoC while the usual care arm will be referred to the physiotherapist where the number and content of sessions are at the patient’s and physiotherapist’s discretion. The CONNACT MoC is a community-based, multidisciplinary 12-week program that uniquely uses an individualized approach based on a triaging criterion to tailor the treatment to each patient in line with the “right care, delivered at the right time, by the right team, in the right place, with the right resources” philosophy coupled with a strong emphasis on patient activation and self-management strategies to promote long term sustainable behavioural change. KOOS4 is the primary outcome measure. Secondary outcomes include KOOS individual subscales, quality of life scoring, functional performance, global, diet and psychological related outcomes. The second component is an economic evaluation of the cost-effectiveness of the CONNACT MoC using a societal perspective. The third component is an implementation and evaluation framework using process evaluation under the RE-AIM framework using a mixed-method approach. Discussion: A rapidly aging global population has resulted in an OA epidemic that is currently being poorly managed on a global scale. CONNACT MoC is a complex intervention that has been developed to meet this growing need. In line with the MRC guidance for developing and evaluating complex interventions, a pilot feasibility study was completed and a comprehensive approach including an RCT, economic evaluation and process evaluation is described in this study protocol. Results from this study will help clinicians, healthcare administrators and policymakers guide the sustainable and effective implementation of the CONNACT MoC for knee OA and serve as a basis for similar multidisciplinary MoC for chronic degenerative musculoskeletal conditions to be developed.Trial Registration: Clinicaltrials.gov Identifier: NCT03809975. Registered January 18 2019. https://clinicaltrials.gov/ct2/show/NCT03809975

scholarly journals Collaborative model of care between Orthopaedics and allied healthcare professionals in knee osteoarthritis (CONNACT): study protocol for an effectiveness-implementation hybrid randomized control trial

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Bryan Yijia Tan ◽  
Michelle Jessica Pereira ◽  
Su-Yin Yang ◽  
David J. Hunter ◽  
Soren Thorgaard Skou ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Mixed Method ◽  
Randomized Control Trial ◽  
Healthcare Professionals ◽  
Model Of Care ◽  
Knee Oa ◽  
Randomized Control ◽  
The Cost ◽  
Method Approach

Abstract Background Knee Osteoarthritis (OA) is a leading cause of global disability. The Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals (CONNACT) Model of Care (MoC) was developed by optimizing evidence-based non-surgical treatments to deliver value-based care for people with knee OA. The primary aim of this study is to determine the clinical effectiveness of the CONNACT MoC (3 months) compared to usual care. The secondary aims are: a) To determine the cost-effectiveness and b) To develop an evaluation and implementation framework to inform large scale implementation for this MoC. Methodology Type 1 Effectiveness-Implementation Hybrid Trial using an explanatory sequential mixed-method approach. The study consists of 3 components. The first component is the pragmatic, parallel-arm, single-blinded randomized control trial. Inclusion criteria are patients with knee OA based on the National Institute of Health and Care Excellence (NICE) criteria with radiographic severity of greater than Kellgren-Lawrence 1, and Knee Injury and OA Outcome Score (KOOS4) of equal or less than 75. Exclusion criteria include other forms of arthritis, history of previous knee arthroplasty or wheelchair-bound patient. KOOS4 is the primary outcome measure at 3 months, 6 months and 1 year. Secondary outcomes include KOOS individual subscales, quality of life scoring, functional performance, global, diet and psychological related outcomes. The second component is an economic evaluation of the cost-effectiveness of the CONNACT MoC using a societal perspective. The third component is an implementation and evaluation framework using process evaluation under the RE-AIM framework using a mixed-method approach. Sample size of 100 patients has been calculated. Discussion CONNACT MoC is a complex intervention. In line with the MRC guidance for developing and evaluating complex interventions, a pilot feasibility study was completed and a comprehensive approach including an RCT, economic evaluation and process evaluation is described in this study protocol. Results from this study will help clinicians, healthcare administrators and policymakers guide the sustainable and effective implementation of the CONNACT MoC for knee OA and serve as a basis for similar multidisciplinary MoC for chronic degenerative musculoskeletal conditions to be developed. Trial registration Clinicaltrials.gov Identifier: NCT03809975. Registered January 182,019.

A Mixed Method Approach to Quality of Life Research: A Case Study Approach

2007 ◽  
Vol 85 (1) ◽  
pp. 145-158 ◽  
Author(s):  
Heather Dunning ◽  
Allison Williams ◽  
Sylvia Abonyi ◽  
Valorie Crooks
Keyword(s):  
Quality Of Life ◽  
Mixed Method ◽  
Case Study Approach ◽  
Mixed Method Approach ◽  
Study Approach ◽  
Quality Of Life Research ◽  
Method Approach

A novel methodology for supporting integration between refugees and host communities: NAUTIA (need assessment under a technological interdisciplinary approach)

2021 ◽  
Author(s):  
Adela Salas-Ruiz ◽  
Andrea A Eras-Almeida ◽  
Rocío Rodríguez-Rivero ◽  
Alberto Sanz-Cobena ◽  
Susana Muñoz-Hernández ◽  
...  
Keyword(s):  
Climate Change ◽  
Quality Of Life ◽  
Mixed Method ◽  
Human Mobility ◽  
Interdisciplinary Approach ◽  
Refugee Camp ◽  
Need Assessment ◽  
Political Conflicts ◽  
Method Approach

Abstract More than 26 million people are recognized globally as refugees and have been forced to flee from their home countries because of poverty, human rights violations, natural disasters, climate change, and other social and political conflicts. What is more, most host communities are usually poor and face social and economic crises. This is why supporting integration between refugees and host communities is imperative at the global humanitarian context. Thereby, this research presents the NAUTIA (Need Assessment under a Technological Interdisciplinary Approach) methodology, an innovative mixed-method approach designed by the Platform on Refugees of the Universidad Politécnica de Madrid. The main objective of NAUTIA is to identify the basic needs of refugees and locals to improve their quality of life through interdisciplinary and inclusive intervention proposals based on technology. The methodology was applied in the permanent Shimelba Refugee Camp (Ethiopia), where energy, shelter, and food security solutions have resulted essential to improve the living conditions of both population groups. The results are useful for researchers, stakeholders, and practitioners from the humanitarian sector as they provide a more innovative and comprehensive way to support the unprecedented global human mobility there is nowadays.

A randomized control trial of stress management for caregivers of stem cell transplant patients: Effect on patient quality of life and caregiver distress

2019 ◽  
Vol 28 (8) ◽  
pp. 1614-1623 ◽  
Author(s):  
Mark L. Laudenslager ◽  
Teresa L. Simoneau ◽  
Susan K. Mikulich‐Gilbertson ◽  
Crystal Natvig ◽  
Benjamin W. Brewer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stem Cell ◽  
Stress Management ◽  
Randomized Control Trial ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Caregiver Distress ◽  
Transplant Patients ◽  
Randomized Control

Results on health-related quality of life and functionality of a patient-centered self-management program in hospitalized COPD: a randomized control trial

2019 ◽  
Vol 42 (25) ◽  
pp. 3687-3695 ◽  
Author(s):  
Laura Lopez-Lopez ◽  
Marie Carmen Valenza ◽  
Janet Rodriguez-Torres ◽  
Irene Torres-Sanchez ◽  
Maria Granados-Santiago ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Control Trial ◽  
Management Program ◽  
Self Management ◽  
Health Related Quality ◽  
Patient Centered ◽  
Related Quality ◽  
Health Related ◽  
Randomized Control
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