Table 3.
Recommendations for implementing osteoarthritis management programs.
| Themes (barriers/enablers) | Related TDF domain(s) | Recommendations and strategies targeted at patients, medical professionals and health systems to overcome barriers and augment enablers for referral to, and participation in osteoarthritis management programs |
| Enabler: opportunity to achieve positive outcomes and potentially avoid joint replacement surgery Enabler: better program promotion, patient and health professional education, and efficient referral processes |
Knowledge Motivation and goals Social influences Environmental context and resources |
For patients and medical professionals: promote program with expected benefits, including alternative approach to surgery |
| Barrier: misinformation about osteoarthritis Barrier: patient and program factors Barrier/enabler: health professional trust, feedback and advice Enabler: better program promotion, patient and health professional education, and efficient referral processes |
Knowledge Beliefs about capabilities Beliefs about consequences Environmental context and resources |
For patients and medical professionals: develop resources (multiple languages) to encourage positive explanations about osteoarthritis including the safety and value of exercise-therapy (regardless of disease severity) For medical professionals: hold practical workshops and develop a ‘community of practice’ to discuss issues and share knowledge |
| Barrier: program access Barrier: patient and program factors Enabler: better program promotion, patient and health professional education, and efficient referral processes |
Knowledge Environmental context and resources |
For patients and medical professionals: provide information about costs (including out of pocket costs) and parking For medical professionals: develop program referral processes that are seamless, simple and fast; promote program to professional organisations For the health system: lower out-of-pocket program costs for individuals through improved reimbursement models for osteoarthritis management programs; increase program accessibility through provision of tele-rehabilitation; evaluate program as part of multidisciplinary care models |
TDF – theoretical domains framework.