Grant: Operating Grant: Knowledge to Action

Bone And Joint Health; Health Policy; Health Services Delivery; Knee Osteoarthritis; Knowledge Translation; Participatory Deisgn; Patient Centered Care; Patient Preferences; Primary Care; Statistical Modeling

<html> <body> <p>Clinical risk management tools developed for patients with chronic diseases can identify those at high risk of progressing to severe stages and can aid family practitioners (FPs) in motivating patients to implement lifestyle changes. Such a tool does not exist for early Knee Osteoarthritis (KOA) patients.</p> <p> <u>Research objective</u>: To bridge the gap between our knowledge about risk of KOA progression and the application of this knowledge in routine clinical practice. We will develop a web-based KOA risk management tool, named KO-Ask that will be used by FPs during patient visits. Patients&rsquo; symptoms combined with x-ray results will be inputted by FPs and the tool will provide an estimated likelihood of progressing to severe stages with accompanying print-outs of self-management recommendations tailored specifically to the patients&rsquo; needs.</p> <p> <u>Pilot research:</u> We have completed two pilot projects that form our knowledge base. In our first pilot project, we developed and validated predictive models of KOA progression using the Vancouver Longitudinal Study of Early Knee-OA (VALSEKO), a longitudinal population-based cohort of people aged 40 to 79 years with knee pain. We developed predictive models for 6-year MRI-assessed progression of KOA using established lists of clinical criteria from systematic literature reviews. We then validated the models against both radiographic and symptomatic KOA outcomes and demonstrated their high discriminative ability. In the second pilot project, our patient engagement researchers identified obstacles in the care pathways for patients with OA through a series of focus groups and interviews.</p> <p> <u>Methods:</u> Building on this foundational knowledge base, we will mobilise the knowledge into practice, and seek input from FPs and patients to co-design the tool. In the first step, we will use Cognitive Task Analysis (CTA) to understand how FPs structure their evaluation of KOA progression and then to guide the development of the KO-Ask tool. Additionally, our KOA patient engagement researchers will lead focus groups specifically designed to engage KOA patients in collaborative research and identify their needs with regard to the proposed tool. In the second step, a participatory design session will be held where a team consisting of scientists, patient representatives and FPs will co-design the paper-version of the tool. Finally, usability tests will be performed and the web-based prototype will be developed. In the last step, the tool will be evaluated in a pilot implementation using dyads of patients and FPs.</p> <p> <u>Outcomes:</u> The final tool will help FPs distinguish those patients who can benefit from intense interventions, providing FPs and patients with a clear picture of the expected course of the disease. It will also provide FPs and patients with evidence-based self-management strategies that have the potential to slow disease progression.</p> <p> <u>Research team:</u> Our multi-disciplinary research team brings diverse expertise needed to conduct and complete this project. Our team consists of OA researchers from University of Calgary and University of British Columbia, KOA patient representatives from Patient and Community Engagement Research (PaCER) program at University of Calgary and primary care research experts from the Enhancing Alberta Primary Care Networks (EnACt) at University of Alberta. Our team also brings together expertise in knowledge translation, biostatistics and health policy.</p> </body> </html>