Process and feasibility of implementing guideline recommendations for the care of osteoarthritis in West Africa
Bibliographic Data
| ID | 21880960 |
|---|---|
| Authors | Opeyemi Babatunde (0000-0002-5064-6446, Keele University), Oladapo Adetunji (0000-0002-3474-0029, University of Ibadan), Ibidunni Alonge (0000-0003-3679-0836, University of Ibadan), Tolulope Owoyemi (0009-0002-4653-0376, University of Ibadan), Ebunoluwa Ayinmode (0009-0005-3266-0219, West African Institute for Applied Health Research, Ibadan, Nigeria), Adebimpe Ogunbanjo (0009-0000-0157-328X, Lagos State Health Service Commission), Simon White (0000-0003-0096-251X, University Hospitals of North Midlands NHS Trust), Adewale Adebajo Adebajo (0000-0001-7368-7083, University of Sheffield), Christian Mallen (0000-0002-2677-1028, Keele University), Krysia Dziedzic (0000-0002-1168-8993, Keele University) |
| Year | 2025 |
| Volume | 10 |
| Issue | 6 |
| Pages | e018714 |
| Publication date | 2025-06-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMJ Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2024-018714 |
| PMID | 40537272 |
| OpenAlex | W4411455343 |
| Language | EN |
| References cited | 22 |
OBJECTIVES: To assess the feasibility of a guideline-informed model of care for osteoarthritis in primary healthcare and community pharmacy settings in the West African context. METHODS: Joint Implementation of Guidelines for OSteoArthritis in West-Africa (JIGSAW-A): (1) focus groups (n=4) with patients, community pharmacists and healthcare professionals (HCPs) to identify patient preferences and support needs of HCPs; (2) stakeholders resource contextualisation/codesign (ie, osteoarthritis guidebook in local languages, HCPs training/support package). Iterative codesign workshops (n=3) using participatory approaches, model osteoarthritis consultation simulations and consensus agreement.Phase 3: following training and a 12-week pilot implementation period, patient-reported quality of care was assessed by the OsteoArthritis Quality Indicator questionnaire (modified 9-item scale 0%-100%, 100%=best), and implementation of the JIGSAW-A model of care was evaluated using the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. Patient and HCP interviews explored barriers and facilitators, usefulness and acceptability. In phase 4, recommendations for further scale-up and wider implementation of integrated osteoarthritis care were specified. RESULTS: Phases 1-2 highlight the burden and impact of everyday living with joint pain and misinformation which affects help-seeking. Participants expressed the need for a broad information and education campaign and access to self-management support, which informed iterative contextualisation of osteoarthritis care and patient information resources used to support pilot implementation in phase 3.Over 12 weeks, 12 HCPs (community pharmacies, physiotherapists and doctors) were involved in evaluation across nine sites. Of 369 patient consultations that were reported, high rates of quality indicator achievement were found for self-management advice (97%), topical analgesic use (89%) and exercise recommendations (87%). Compliance with full patient assessment in line with the protocol was poor (17%). CONCLUSIONS: We found that evidence-based care for osteoarthritis, involving community pharmacies (as a usual first point of call) and other primary care clinicians, is feasible and may improve aspects of care in low-resource settings. Further research is needed to ascertain long-term sustainability and cost-effectiveness
Business · Focus group · Guideline · Health care · Medical education · Political science · Clinical practice guidelines implementation · Diabetes Management and Education · Medicine · Nursing · Osteoarthritis Treatment and Mechanisms
| Citation velocity | historical |
|---|---|
| Highly cited | No |