Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a...

Area of Science:

• Implementation Science
• Primary Care Research
• Health Workforce Development

Background:

• Consistent evidence-practice gaps in osteoarthritis (OA) care are prevalent in primary care globally.
• Effective delivery of high-value OA care necessitates understanding current barriers faced by healthcare professionals and trainees.
• Building workforce capacity is essential for improving OA patient outcomes.

Purpose of the Study:

• To explore the barriers encountered by clinicians and students in delivering high-value osteoarthritis care.
• To identify specific challenges across different professional groups and training levels.
• To inform strategies for enhancing OA care delivery in primary care settings.

Main Methods:

• A multinational, cross-sectional survey study involving clinicians (physiotherapists, nurses, general practitioners) and final-year medical and physiotherapy students.
• Participants were sampled from Australia, New Zealand, and Canada.
• The survey utilized implementation science domains to measure barriers through categorical and free-text responses.

Main Results:

• Clinicians identified 'health system' and 'patient-related factors' as primary barriers (25-42% and 20-36%).
• Students reported 'knowledge and skills' and 'patient-related factors' as most significant barriers (16-24% and 19-28%).
• Qualitative data revealed skills gaps in exercise tailoring, nutritional advice, behavior change support, assessment, and knowledge translation, alongside infrastructure, patient beliefs, workforce issues, and system pressures.

Conclusions:

• Clinicians and students face multifaceted barriers to high-value OA care at micro (practice/training), meso (service environments), and macro (health system) levels.
• These barriers encompass skills deficits, patient-related challenges, workforce inconsistencies, and systemic pressures.
• Addressing these identified barriers is critical for improving the quality and consistency of osteoarthritis care.