Disentangling treatment pathways for knee osteoarthritis: a study protocol for the TREATright study including a prospective cohort study, a qualitative study and a cost-effectiveness study

Simon Majormoen Bruhn, Lina Holm Ingelsrud, Thomas Bandholm, Søren Thorgaard Skou, Henrik M Schroder, Susanne Reventlow, Anne Møller, Jakob Kjellberg, Thomas Kallemose, Anders Troelsen

Abstract

INTRODUCTION: Knee osteoarthritis (OA) is associated with chronic knee pain and functional disability that negatively affect the ability to carry out normal daily activities. Patients are offered a large variety of non-surgical treatments, often not in accordance with clinical guidelines. This observational study will provide a comprehensive overview of treatment pathways for knee OA during the first 2 years after consulting an orthopaedic surgeon, including timing and order of treatment modalities, predictors of treatment outcomes, cost-effectiveness of treatment pathways and patients' views on different treatment pathways.

METHODS AND ANALYSIS: Patients with primary referrals to an orthopaedic surgeon due to knee OA are consecutively invited to participate and fill out a questionnaire prior to their consultation with an orthopaedic surgeon. Follow-up questionnaires will be obtained at 6 and 24 months after inclusion. Based on a prospective cohort study design, including questionnaires and register data, we will (1) describe treatment pathways for knee OA during the first 2 years after consulting an orthopaedic surgeon; (2) describe the characteristics of patients choosing different treatment pathways; (3) develop predictive models for patient-self-determined classifications of good and poor treatment outcomes; (4) evaluate the cost-effectiveness of treatment pathways that live up to clinical guidelines versus pathways that do not; based on a qualitative study design using semistructured individual interviews, we will (5) describe the patients' perspectives on treatment pathways for knee OA.

ETHICS AND DISSEMINATION: The study is approved by the Danish regional ethical committee (journal number H-17017295) and the Danish Data Protection Agency (journal number AHH-2017-072). Data will be anonymised and handled in line with the General Data Protection Regulation and the Danish Data Protection Act. The study results will be submitted to international open-access peer-reviewed journals and disseminated at conferences.

TRIAL REGISTRATION NUMBER: NCT03746184, pre-results.

Original languageEnglish
Article numbere048411
JournalBMJ Open
Volume11
Issue number7
Pages (from-to)1-11
Number of pages11
ISSN2044-6055
DOIs
Publication statusPublished - 7 Jul 2021

Keywords

  • knee
  • musculoskeletal disorders
  • orthopaedic & trauma surgery
  • quality in healthcare
  • rehabilitation medicine

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