Jordan, KP, Edwards, JJ, Porcheret, M, Healey, EL, Jinks, C, Bedson, J, Clarkson, K, Hay, EM and Dziedzic, KS (2017) Effect of a model consultation informed by guideline on recorded quality of care of osteoarthritis (MOSAICS): a cluster randomised controlled trial in primary care. Osteoarthritis and Cartilage, 25 (10). pp. 1588-1597. ISSN 1522-9653

[thumbnail of K Jordan - Effect of a model consultation informed by guidelines on recorded quality....pdf]
K Jordan - Effect of a model consultation informed by guidelines on recorded quality....pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (393kB) | Preview


To determine the effect of a model osteoarthritis (OA) consultation (MOAC) informed by National Institute for Health and Care Excellence (NICE) recommendations compared with usual care on recorded quality of care of clinical OA in general practice.

Two-arm cluster randomised controlled trial.

Eight general practices in Cheshire, Shropshire, or Staffordshire UK.

General practitioners and nurses with patients consulting with clinical OA.

Following six-month baseline period practices were randomised to intervention (n = 4) or usual care (n = 4). Intervention practices delivered MOAC (enhanced initial GP consultation, nurse-led clinic, OA guidebook) to patients aged ≥45 years consulting with clinical OA. An electronic (e-)template for consultations was used in all practices to record OA quality care indicators.

Quality of OA care over six months recorded in the medical record.

1851 patients consulted in baseline period (1015 intervention; 836 control); 1960 consulted following randomisation (1118 intervention; 842 control). At baseline wide variations in quality of care were noted. Post-randomisation increases were found for written advice on OA (4–28%), exercise (4–22%) and weight loss (1–15%) in intervention practices but not controls (1–3%). Intervention practices were more likely to refer to physiotherapy (10% vs 2%, odds ratio 5.30; 95% CI 2.11, 13.34), and prescribe paracetamol (22% vs 14%, 1.74; 95% CI 1.27, 2.38).

The intervention did not improve all aspects of care but increased core NICE recommendations of written advice on OA, exercise and weight management. There remains a need to reduce variation and uniformly enhance improvement in recorded OA care.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: osteoarthritis, general practice, implementation, primary care, guidelines
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 05 Jun 2017 08:36
Last Modified: 07 Mar 2019 16:33

Actions (login required)

View Item
View Item