Engaging in an evidence-based osteoarthritis management program: Referrer and patient perspectives

Dr Christian Barton1,2, Mr James Sherwood3, A/Prof  Ilana Ackerman3,4, Dr Tash Brusco3, Ms Sophie Jennnings3, Mr Kirby Young3, Prof Kay Crossley1, Dr Jo Kemp1, Dr Jason Wallis1,3

1La Trobe Sport And Exercise Medicine Research Centre, , , 2Deparment of Surgery, St Vincents Hospital, University of Melbourne, , , 3Cabrini Hospital, , , 4Monash University, ,


Aim: To explore barriers and enablers (from referrer and patient perspectives) to engagement with an evidence-based, 8-week physiotherapy-led education and exercise program for knee osteoarthritis (OA).

Method: Semi-structured individual interviews were conducted with people with knee OA and potential referrers (GPs, surgeons, rheumatologists) to physiotherapy care. We explored barriers and enablers to participation in a specific 8-week OA education and exercise program – Good Life with osteoArthritis from Denmark (GLA:D®), as well as other non-surgical and surgical care for knee OA. Initial framework analysis was followed by an inductive and grounded approach, supported by NVivo software, until no new themes emerged.

Results: Twenty people with knee OA (including 10 who had completed GLA:D®), and 15 doctors (5 GPs, 5 surgeons, 5 Rheumatologists) participated in the interviews. Key barriers to education and exercise participation perceived by both patients and referrers included financial and physical access issues, and beliefs that other treatments would be more beneficial (pharmaceuticals, surgery). Key enablers perceived by both patients and referrers included a doctors’ recommendation and program availability. Patients also highlighted time constraints as a key barrier, and that understanding OA and the potential benefits of exercise was a key enabler.

Significance of the findings to allied health: Participation in evidence-based knee OA programs such as GLA:D® may be increased by improving access (funding and service availability), and developing resources to educate patients and doctors about the value of education and exercise for knee OA management.


Dr Barton works in both research and private practice treating sports and musculoskeletal patients in Melbourne. He currently holds a Post-Doctoral Research Fellow and is the Communications Manager at La Trobe’s Sport and Exercise Medicine Research Centre. He is currently studying a Communications Masters focussed on Journalism Innovation. Dr Barton is an Associate Editor and Deputy Social Media Editor at the British Journal of Sports Medicine. Locally, he is on the board of the Victorian branch of the Musculoskeletal Physiotherapy Association, is a guest lecturer at La Trobe University and the University of Melbourne, and provides regularly workshops to physiotherapy groups.

Dr Barton’s research interests focus on knee, running injuries and knowledge translation including the use of innovative digital technologies. He is regularly an invited speaker both nationally and internationally, presenting on these topics. Additionally, he runs popular courses on knee pain and running injury management in Australia, the United Kingdom, Europe and Scandinavia.