Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study
Objective: Consistent evidence-practice gaps in osteoarthritis (OA) care are observed in primary care settings globally. Building workforce capacity to deliver high-value care requires a contemporary understanding of barriers to care delivery. We aimed to explore barriers to OA care delivery among c...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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ELSEVIER SCI LTD
2019
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1079078 http://hdl.handle.net/20.500.11937/93245 |
| _version_ | 1848765717943418880 |
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| author | Briggs, Andrew Houlding, E. Hinman, R.S. Desmond, L.A. Bennell, K.L. Darlow, B. Pizzari, T. Leech, M. MacKay, C. Larmer, P.J. Bendrups, A. Greig, A.M. Francis-Cracknell, A. Jordan, J.E. Slater, Helen |
| author_facet | Briggs, Andrew Houlding, E. Hinman, R.S. Desmond, L.A. Bennell, K.L. Darlow, B. Pizzari, T. Leech, M. MacKay, C. Larmer, P.J. Bendrups, A. Greig, A.M. Francis-Cracknell, A. Jordan, J.E. Slater, Helen |
| author_sort | Briggs, Andrew |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: Consistent evidence-practice gaps in osteoarthritis (OA) care are observed in primary care settings globally. Building workforce capacity to deliver high-value care requires a contemporary understanding of barriers to care delivery. We aimed to explore barriers to OA care delivery among clinicians and students. Design: A cross-sectional, multinational study sampling clinicians (physiotherapists, primary care nurses, general practitioners (GPs), GP registrars; total possible denominator: n = 119,735) and final-year physiotherapy and medical students (denominator: n = 2,215) across Australia, New Zealand and Canada. Respondents answered a survey, aligned to contemporary implementation science domains, which measured barriers to OA care using categorical and free-text responses. Results: 1886 clinicians and 1611 students responded. Items within the domains ‘health system’ and ‘patient-related factors’ represented the most applicable barriers experienced by clinicians (25–42% and 20–36%, respectively), whereas for students, ‘knowledge and skills’ and ‘patient-related factors’ (16–24% and 19–28%, respectively) were the most applicable domains. Meta-synthesis of qualitative data highlighted skills gaps in specific components of OA care (tailoring exercise, nutritional/overweight management and supporting positive behaviour change); assessment, measurement and monitoring; tailoring care; managing case complexity; and translating knowledge to practice (especially among students). Other barriers included general infrastructure limitations (particularly related to community facilities); patient-related factors (e.g., beliefs and compliance); workforce-related factors such as inconsistent care and a general knowledge gap in high-value care; and system and service-level factors relating to financing and time pressures, respectively. Conclusions: Clinicians and students encounter barriers to delivery of high-value OA care in clinical practice/training (micro-level); within service environments (meso-level); and within the health system (macro-level). |
| first_indexed | 2025-11-14T11:39:42Z |
| format | Journal Article |
| id | curtin-20.500.11937-93245 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:39:42Z |
| publishDate | 2019 |
| publisher | ELSEVIER SCI LTD |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-932452023-10-06T06:57:42Z Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study Briggs, Andrew Houlding, E. Hinman, R.S. Desmond, L.A. Bennell, K.L. Darlow, B. Pizzari, T. Leech, M. MacKay, C. Larmer, P.J. Bendrups, A. Greig, A.M. Francis-Cracknell, A. Jordan, J.E. Slater, Helen Science & Technology Life Sciences & Biomedicine Orthopedics Rheumatology Interprofessional Implementation Service delivery System KNEE OSTEOARTHRITIS PHYSICAL-THERAPISTS MANAGEMENT GUIDELINES QUALITY APPROPRIATENESS DELIVERY BELIEFS MODELS HIP Implementation Interprofessional Service delivery System Adult Attitude of Health Personnel Clinical Competence Cross-Sectional Studies Delivery of Health Care Educational Status Female Health Care Surveys Health Personnel Health Services Accessibility Humans Male Middle Aged Osteoarthritis Students Humans Osteoarthritis Health Care Surveys Cross-Sectional Studies Attitude of Health Personnel Students Clinical Competence Adult Middle Aged Health Personnel Educational Status Delivery of Health Care Health Services Accessibility Female Male Objective: Consistent evidence-practice gaps in osteoarthritis (OA) care are observed in primary care settings globally. Building workforce capacity to deliver high-value care requires a contemporary understanding of barriers to care delivery. We aimed to explore barriers to OA care delivery among clinicians and students. Design: A cross-sectional, multinational study sampling clinicians (physiotherapists, primary care nurses, general practitioners (GPs), GP registrars; total possible denominator: n = 119,735) and final-year physiotherapy and medical students (denominator: n = 2,215) across Australia, New Zealand and Canada. Respondents answered a survey, aligned to contemporary implementation science domains, which measured barriers to OA care using categorical and free-text responses. Results: 1886 clinicians and 1611 students responded. Items within the domains ‘health system’ and ‘patient-related factors’ represented the most applicable barriers experienced by clinicians (25–42% and 20–36%, respectively), whereas for students, ‘knowledge and skills’ and ‘patient-related factors’ (16–24% and 19–28%, respectively) were the most applicable domains. Meta-synthesis of qualitative data highlighted skills gaps in specific components of OA care (tailoring exercise, nutritional/overweight management and supporting positive behaviour change); assessment, measurement and monitoring; tailoring care; managing case complexity; and translating knowledge to practice (especially among students). Other barriers included general infrastructure limitations (particularly related to community facilities); patient-related factors (e.g., beliefs and compliance); workforce-related factors such as inconsistent care and a general knowledge gap in high-value care; and system and service-level factors relating to financing and time pressures, respectively. Conclusions: Clinicians and students encounter barriers to delivery of high-value OA care in clinical practice/training (micro-level); within service environments (meso-level); and within the health system (macro-level). 2019 Journal Article http://hdl.handle.net/20.500.11937/93245 10.1016/j.joca.2018.12.024 English http://purl.org/au-research/grants/nhmrc/1079078 http://purl.org/au-research/grants/nhmrc/1132548 http://purl.org/au-research/grants/arc/FT130100175 http://purl.org/au-research/grants/nhmrc/1058440 ELSEVIER SCI LTD unknown |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Orthopedics Rheumatology Interprofessional Implementation Service delivery System KNEE OSTEOARTHRITIS PHYSICAL-THERAPISTS MANAGEMENT GUIDELINES QUALITY APPROPRIATENESS DELIVERY BELIEFS MODELS HIP Implementation Interprofessional Service delivery System Adult Attitude of Health Personnel Clinical Competence Cross-Sectional Studies Delivery of Health Care Educational Status Female Health Care Surveys Health Personnel Health Services Accessibility Humans Male Middle Aged Osteoarthritis Students Humans Osteoarthritis Health Care Surveys Cross-Sectional Studies Attitude of Health Personnel Students Clinical Competence Adult Middle Aged Health Personnel Educational Status Delivery of Health Care Health Services Accessibility Female Male Briggs, Andrew Houlding, E. Hinman, R.S. Desmond, L.A. Bennell, K.L. Darlow, B. Pizzari, T. Leech, M. MacKay, C. Larmer, P.J. Bendrups, A. Greig, A.M. Francis-Cracknell, A. Jordan, J.E. Slater, Helen Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study |
| title | Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study |
| title_full | Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study |
| title_fullStr | Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study |
| title_full_unstemmed | Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study |
| title_short | Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study |
| title_sort | health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study |
| topic | Science & Technology Life Sciences & Biomedicine Orthopedics Rheumatology Interprofessional Implementation Service delivery System KNEE OSTEOARTHRITIS PHYSICAL-THERAPISTS MANAGEMENT GUIDELINES QUALITY APPROPRIATENESS DELIVERY BELIEFS MODELS HIP Implementation Interprofessional Service delivery System Adult Attitude of Health Personnel Clinical Competence Cross-Sectional Studies Delivery of Health Care Educational Status Female Health Care Surveys Health Personnel Health Services Accessibility Humans Male Middle Aged Osteoarthritis Students Humans Osteoarthritis Health Care Surveys Cross-Sectional Studies Attitude of Health Personnel Students Clinical Competence Adult Middle Aged Health Personnel Educational Status Delivery of Health Care Health Services Accessibility Female Male |
| url | http://purl.org/au-research/grants/nhmrc/1079078 http://purl.org/au-research/grants/nhmrc/1079078 http://purl.org/au-research/grants/nhmrc/1079078 http://purl.org/au-research/grants/nhmrc/1079078 http://hdl.handle.net/20.500.11937/93245 |