Implementing good life with OsteoArthritis from Denmark (GLA:D®) in public outpatient settings in Tasmania, Australia

Good Life with OsteoArthritis in Denmark (GLA:D®) is an evidence-based education and exercise program for people with hip or knee osteoarthritis. The program largely operates in private healthcare settings around the world. This study evaluated its implementation and delivery in public outpatient settings in Tasmania, Australia.

A process and outcome evaluation was conducted to evaluate the implementation and delivery of GLA:D® within the publicly funded Tasmanian Health Service. The evaluation was conducted using the RE-AIM QuEST Framework, including health system and service-level metrics, patient-level data and program fidelity. Semi-structured focus groups and qualitative interviews were conducted with staff and patients who participated in the program, with thematic analysis of the outputs.

Implementation and Adoption: GLA:D® was implemented at three outpatient clinics. Successful implementation factors included GLA:D® being a recognisable evidence-based program that was straightforward to deliver, executive support and buy-in, local physiotherapist champions, and the establishment of an eReferral pathway which improved efficiency. Reach: Twelve physiotherapists were trained in GLA:D®, while 89 patients enrolled in the program (21 cohorts), of which 63 participated in the GLA:D® registry at baseline. Effectiveness: Most patients noted improvements in symptoms; however, some patients with co-morbidities or complex pain did not benefit. Maintenance. All three centres have elected to continue the program.

GLA:D® can be effectively, efficiently and sustainably implemented in public outpatient settings. Operational and administrative considerations have been identified and provide a foundation for broader implementation of the program in public and regional settings.