TY - JOUR
T1 - Advanced Practice Physiotherapists and the implementation of the JIGSAW-E model for the management of osteoarthritis in Scottish primary care settings
T2 - a qualitative case study
AU - Frost, H.
AU - Tooman, T.
AU - Cowie, J.
AU - Gillespie, N.
AU - Ackerman, P.
AU - Krievs, E.
AU - Dziedzic, K.
N1 - Funding Information:
This work was undertaken by and on behalf of The Scottish Improvement Science Collaborating Centre with support from EIT Health. The Scottish Improvement Science Collaborating Centre (SISCC) is funded by the Scottish Funding Council, Chief Scientist's Office, NHS Education for Scotland, and The Health Foundation with substantial additional investment from partner organisations. KD is part funded by the National Institute for Health and Care Research (NIHR) Applied Health Research Collaboration (ARC) West Midlands (NIHR 200165). KD was also part funded by an NIHR Knowledge Mobilisation Research Fellowship (KMRF-2014–03–002) and is an NIHR Senior Investigator (ID NIHR 200259). MOSAICS research was funded by the National Institute for Health Research (NIHR) Programme Grant (RP-PG-0407–10386). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. This research was also funded by the Arthritis Research UK Centre in Primary Care grant (Grant Number 18139).
Copyright:
© 2022 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
PY - 2022/12
Y1 - 2022/12
N2 - Objective: To explore the acceptability, barriers and enablers of NICE guidelines for osteoarthritis in the Scottish primary care setting using the Joint Implementation of Guidelines for Osteoarthritis in Western Europe (JIGSAW-E) model and investigate the role of Advanced Physiotherapy Practitioners (APPs) in providing evidence-based care.Design: A qualitative case study comprised of semi-structured interviews followed by a workshop with participants.Setting: 10 Scottish primary care practices.Participants: Six general practitioners (GPs) and eight APPs were interviewed. Twenty-three practitioners attended the workshop including 22 physiotherapists and one GP.Results: While both GPs and APPs recognised the need to improve and standardise osteoarthritis care delivery, this study found that APPs were better situated to implement the evidence-based model. Barriers to implementation included lack of time for training, limited appointment time for GPs to consult and discuss medication use with patients, limitation of disease specific guidelines for patients with complex multimorbidity, and system-based barriers such as electronic data collection and high staff turnover. The key enabler was practitioners’ motivation to provide optimal, standardised quality care for osteoarthritis. To increase acceptance, ownership and usability for both practitioners and patients, the JIGSAW-E model materials required adaptation to the local context.Conclusion: This study provides evidence that the JIGSAW-E model is acceptable in Scottish primary care. Furthermore, the evolving roles of GPs and APPs within multidisciplinary primary care teams provides a platform to implement the JIGSAW-E model, where APPs are well placed to provide leadership and training in the delivery of evidence-based care for osteoarthritis.
AB - Objective: To explore the acceptability, barriers and enablers of NICE guidelines for osteoarthritis in the Scottish primary care setting using the Joint Implementation of Guidelines for Osteoarthritis in Western Europe (JIGSAW-E) model and investigate the role of Advanced Physiotherapy Practitioners (APPs) in providing evidence-based care.Design: A qualitative case study comprised of semi-structured interviews followed by a workshop with participants.Setting: 10 Scottish primary care practices.Participants: Six general practitioners (GPs) and eight APPs were interviewed. Twenty-three practitioners attended the workshop including 22 physiotherapists and one GP.Results: While both GPs and APPs recognised the need to improve and standardise osteoarthritis care delivery, this study found that APPs were better situated to implement the evidence-based model. Barriers to implementation included lack of time for training, limited appointment time for GPs to consult and discuss medication use with patients, limitation of disease specific guidelines for patients with complex multimorbidity, and system-based barriers such as electronic data collection and high staff turnover. The key enabler was practitioners’ motivation to provide optimal, standardised quality care for osteoarthritis. To increase acceptance, ownership and usability for both practitioners and patients, the JIGSAW-E model materials required adaptation to the local context.Conclusion: This study provides evidence that the JIGSAW-E model is acceptable in Scottish primary care. Furthermore, the evolving roles of GPs and APPs within multidisciplinary primary care teams provides a platform to implement the JIGSAW-E model, where APPs are well placed to provide leadership and training in the delivery of evidence-based care for osteoarthritis.
KW - Advanced Practice Physiotherapy
KW - Guidelines Implementation
KW - Osteoarthritis
UR - http://www.scopus.com/inward/record.url?scp=85139875407&partnerID=8YFLogxK
U2 - 10.1016/j.physio.2022.08.007
DO - 10.1016/j.physio.2022.08.007
M3 - Article
C2 - 36244276
AN - SCOPUS:85139875407
SN - 0031-9406
VL - 117
SP - 81
EP - 88
JO - Physiotherapy (United Kingdom)
JF - Physiotherapy (United Kingdom)
ER -