Abstract
Background: The burden of osteoarthritis (OA) to individuals and health systems is substantial and is expected toincrease due to population ageing and rising prevalence of obesity and multimorbidity. Primary care-based models of care (MoCs) are being increasingly developed in response to this growing burden. However, these MoCs have yet to be formally reviewed. A MoC can be defined as an 'evidence-informed strategy, framework or pathway that outlines the optimal manner in which condition-specific care should be delivered to consumers within a local health system'. Objective: To identify and describe the available research regarding the extent, nature and characteristics of MoCs for OA that have been developed or evaluated in primary care. Methods: A scoping review will be conducted in accordance with the Arksey and O'Malley scoping review framework and the PRISMA-ScR guidelines. Systematic literature searches of MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science and LILACs will be conducted from 2010 to present, aligning with publication dates of recent clinical guidelines. A structured iterative search of grey literature will be conducted. Full-text original quantitative or mixed method studies which describe the development or evaluation of MoCs for OA in primary care will be considered. Data will be charted and synthesised and a narrative synthesis will be conducted. Conclusions: This scoping review will provide a broad overview regarding the extent, nature and characteristics of the available literature on primary care based MoCs for OA. Findings will be used to identify gaps in the current evidence to identify areas for future research.
Highlights
Osteoarthritis (OA) is the most common joint disease in the world[1] and is characterised by abnormal joint tissue metabolism, cartilage degradation, bone remodelling, osteophyte formation, joint inflammation, and loss of normal joint function[2]. It currently ranks as the 15th highest contributor to disability globally[3], affecting more than 500 million people worldwide[4]. It is the third fastest growing cause of years lived with disability[3], with the number of people living with OA globally rising by 48% from 1990 to 20194
Co-morbid with other chronic health conditions such as hypertension, heart disease and diabetes[10], OA negatively impacts upon the morbidity and mortality associated with these conditions[11]
What are the findings reported in studies evaluating the Model of Care (MoC)?
Summary
Study design A scoping review was deemed the most suitable review methodological approach, given the broad and heterogeneous nature of the research questions to be addressed. The scoping review framework proposed by Arksey and O’Malley[29] will be employed This framework suggests five steps for a rigorous scoping review: (1) identifying the research questions; (2) searching for relevant studies; (3) selecting studies; (4) charting the data, and; (5) collating, summarising, analysing and presenting the results. This framework highlights the need for scoping reviews to be an iterative process, based on initial searches, producing best results, and expert discussion[30]. The data charted will include specific details about the population, concept, context, study methods and key findings significant to the scoping review questions. Suggestions for future research based on the study findings will be summarised
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