Collaborative Model of Care Between Orthopaedics and Allied Healthcare Professionals Trial (CONnACT)

Summary

Osteoarthritis knee is the leading cause of chronic disability among older adults. Our current model of care is doctor-centric and inefficient leading to suboptimal use of allied health intervention for effective lifestyle and behaviour changes resulting in potentially, unnecessary surgery.

The study is designed using an effectiveness-implementation hybrid study design utilizing a mixed methods approach. The hybrid study has dual aims. The primary aim is to evaluate the clinical effectiveness (pain, function and quality of life) of a 12-week multidisciplinary (Orthopaedics, Physiotherapy, Dietetics, Psychology) personalized, community-based program for patients with knee osteoarthritis through a randomized-controlled trial. The secondary aim is to obtain data that will inform the context for implementation and guide future wider scale application. The investigators hypothesize that this multidisciplinary program is clinically more effective in the treatment of knee osteoarthritis at 12 months compared to standard care.

Conditions

• Osteoarthritis

Interventions

OTHER

Multidisciplinary Community Program

Patient will undergoes 12 weeks of structured and personalized multidisciplinary community-based program, which consists of Physiotherapy, Dietetics and Psychology sessions. Patients will also attend 2 educational sessions. Physiotherapy and educational sessions are mandatory for all participants, while the need for dietetics and psychological interventions are determine using individual's BMI measurements and psychological questionnaires. Inclusion criteria: Dietetics: 23.5 \< BMI \<32.5; Psychology: PEG \> 4 or PHQ-4 \> 5 or PAM level \< 3

OTHER

Current model of care

No controlled set of treatment assigned to patient. It is based totally on the discretion of the attending clinicians. It will generally contain an unspecific number of physiotherapy sessions. Other allied health involvement such as dietetics and psychological interventions will be on an ad hoc basis. In some cases, the orthopaedic surgeon may recommend for surgery.

Sponsors & Collaborators

• University of Southern Denmark

  collaborator OTHER

• Nanyang Technological University

  collaborator OTHER

• Singapore General Hospital

  collaborator OTHER

• University of Sydney

  collaborator OTHER

• Tan Tock Seng Hospital

  lead OTHER

Principal Investigators

• Bryan Tan, MBBS, MRCS · Tan Tock Seng Hospital

• Soren Skou, PT, PhD · University of Southern Denmark

• Josip Car, MD, PhD · Nanyang Technological University

• Julian Thumboo, MBBS, FRCP · Singapore General Hospital

• David Hunter, MBBS, PhD · University of Sydney

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

45 Years

Max Age

99 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-09-18

Primary Completion

2021-02-01

Completion

2021-12-31

Countries

• Singapore

Study Locations