What affects the implementation of lifestyle interventions in patients with osteoarthritis? A multidisciplinary focus group study among healthcare professionals

To identify factors affecting the implementation of lifestyle interventions (LIs) in patients with hip and/or knee osteoarthritis (OA) from the perspective of primary and secondary healthcare professionals (HCPs) in the Dutch healthcare system. Multidisciplinary focus groups were composed. Data analysis was performed following thematic analysis. The Tailored Implementation for Chronic Diseases checklist was used to guide data analysis. Four focus groups meetings were conducted with 38 participating HCPs (general practitioners (or in-training), orthopedic surgeons (or in-training), physiotherapists, dieticians, a general practice assistant, lifestyle counselors, and nurse practitioners). Influencing factors were grouped into nine themes: (1) intervention factors; (2) individual HCP factors; (3) patient factors; (4) professional interactions; (5) incentives and resources; (6) capacity for organizational change; (7) social, political and legal factors; (8) patient and HCP interactions; and (9) disease factors. A wide variety of factors affecting the implementation of LIs was identified in this study, where the importance of effective interdisciplinary collaboration was emphasized by the multidisciplinary group of participants. This thorough analysis of influencing factors is an important first step toward improved implementation of LIs within OA care. Further research is required to identify the most significant targets for change in daily practice.Implications for RehabilitationThe implementation of lifestyle interventions (LIs) by healthcare professionals (HCPs) in patients with hip and/or knee osteoarthritis (OA) is affected by both individual and environmental factors.The influencing factors identified in this study can support the development of interventions aimed at improving the implementation of LIs in OA care.A multilevel approach is required when developing interventions to improve the implementation of LIs in OA care.Continued efforts of both primary and secondary HCPs and policymakers are needed in order to promote the use of LIs within OA care. The implementation of lifestyle interventions (LIs) by healthcare professionals (HCPs) in patients with hip and/or knee osteoarthritis (OA) is affected by both individual and environmental factors. The influencing factors identified in this study can support the development of interventions aimed at improving the implementation of LIs in OA care. A multilevel approach is required when developing interventions to improve the implementation of LIs in OA care. Continued efforts of both primary and secondary HCPs and policymakers are needed in order to promote the use of LIs within OA care.

本研究旨在从荷兰医疗体系中初级和次级医疗保健专业人员（HCPs）的视角，识别影响髋部和/或膝关节骨关节炎（OA）患者生活方式干预（LIs）实施的因素。研究组成了多学科焦点小组，并按照主题分析方法进行了数据分析。研究使用了定制慢性病实施清单（Tailored Implementation for Chronic Diseases）以指导数据分析。共进行了四次焦点小组会议，共有38名参与人员（包括全科医生（或正在接受培训）、骨科外科医生（或正在接受培训）、物理治疗师、营养师、全科助理、生活方式顾问和护士实践者）。影响因素被分为九个主题：（1）干预因素；（2）个体HCP因素；（3）患者因素；（4）专业互动；（5）激励和资源；（6）组织变革能力；（7）社会、政治和法律因素；（8）患者与HCP互动；（9）疾病因素。本研究识别了影响LIs实施的多方面因素，其中多学科参与者强调了有效跨学科合作的重要性。对影响因素的深入分析是提高OA护理中LIs实施的重要第一步。为进一步识别实践中最显著的改变目标，需要进行进一步的研究。对于康复的意义：医疗保健专业人员（HCPs）在髋部和/或膝关节骨关节炎（OA）患者中实施生活方式干预（LIs）受到个体和环境因素的共同影响。本研究中识别的影响因素可支持旨在改善OA护理中LIs实施的发展干预措施。在开发旨在改善OA护理中LIs实施的干预措施时，需要采用多层次方法。为了推广OA护理中LIs的使用，需要初级和次级HCPs以及政策制定者的持续努力。