Strategies to Implement Knee Osteoarthritis Guidelines in Switzerland

Knee osteoarthritis (KOA) is a common chronic disease in Switzerland, associated with high socioeconomic costs and increasing prevalence due to aging and other risk factors. International guidelines recommend a stepped approach focusing on exercise, education, and weight management; however, implementation remains inconsistent. Switzerland has one of the highest knee replacement rates among OECD countries, suggesting potential overuse and indicating an evidence-performance gap in KOA management.

Current efforts promote coordinated, patient-centered care. A repeated stakeholder dialogue in 2024 with representatives of medical and physiotherapy associations, patient organizations, health insurers, and researchers identified challenges: variation in patient pathways across providers; non-evidence-based treatment sequencing with premature escalation to specialist care; and misalignment of expectations between patients and providers.

Proposed strategies include: (1) establishing a national Model of Care based on a consensus treatment framework; (2) strengthening patient health literacy through targeted education; and (3) facilitating patient navigation through effective communication and shared decision-making.

Closing the evidence-performance gap requires collaboration among healthcare providers to improve outcomes, reduce inappropriate care, and support coordinated patient-centered KOA management in Switzerland.