Effectiveness of an interactive postgraduate educational intervention with patient participation on the adherence to a physiotherapy guideline for hip and knee osteoarthritis: a randomised controlled trial

Abstract

Purpose: To determine the effectiveness of an interactive educational intervention on a physiotherapy guideline for hip and knee osteoarthritis. Method: Physiotherapists were randomly allocated to a 3-h interactive educational course with the collaboration of three patient partners or no intervention. Assessments comprised questionnaires on adherence (score range 0–24), knowledge (score range 0–76), and barriers to use the guideline (score range 0–80). Assessments were conducted 1 week before the interactive course (T0) immediately after (T1), and 3 months thereafter (T2). Change scores were compared between the groups by means of Mann–Whitney U tests and linear mixed models. Results: 284 of 4328 eligible PTs (7%) were included. The intervention (n = 133) was significantly more effective than no intervention (n = 151) concerning self-reported adherence and knowledge with mean differences in change scores (95% CI) at T1 and T2 being 1.4 (0.7–2.0) and 0.9 (0.2–1.7) for adherence and 6.8 (4.5–9.1) and 3.9 (1.7–6.2) for knowledge, (all p values < 0.005). In both groups the barrier score increased at T1 and decreased at T2, with a significantly larger increase at T1 and decrease at T2 in the intervention group (mean differences 3.1 (1.8–4.4) and 3.3 (0.5–6.1), respectively. Conclusions: A short interactive educational course with patient participation on a PT guideline on hip and knee osteoarthritis showed a small to moderate positive effect on self-reported guideline adherence and knowledge, whereas for perceived barriers an advantage was only seen on the longer term.Implications for RehabilitationContinuing professional development is important and effective, it works very well when patients are engaged in the process, and hence it is supportive overall of enhancing clinical practice.Interactive education can reduce barriers in guideline usage in daily practice.