Making the Case for Virtual Osteoarthritis Management Programs

Abstract

Rationale: Osteoarthritis (OA) is one of Canada’s most prevalent chronic conditions, resulting in a high burden of disease due to common symptoms of chronic pain, limited function, poor mental health, and decreased quality of life. First-line treatments for OA target pain and quality of life through education, exercise, and weight loss. However, many individuals do not participate in first-line approaches, and known barriers exist to in-person formats. Virtual osteoarthritis management programs (OAMP) have the potential to improve access to treatment and address barriers to in-person formats. Objectives: To understand virtual OAMP that include education and exercises by examining the GLA:DTM Canada transition to virtual formats. The objectives are to: 1) Identify and synthesize available guidance for implementing virtual programs 2) Understand participant and clinician perspectives on virtual GLA:DTM 3) Compare GLA:DTM program outcomes between in-person and virtual or hybrid formats Results: Objective 1: A scoping review demonstrated limited guidance available (six peer-reviewed, six grey literature) for clinicians implementing virtual programs. Collectively guidance suggested clinician training, adjustments to consent, education and exercise components, and completing participant screening and safety checks. Objective 2: Participants’ and clinicians’ perspectives were obtained via qualitative descriptive analysis and identified four main themes: 1) expected and unexpected benefits, 2) drawbacks to virtual programs, 3) program delivery in a virtual world, and 4) shifting and non-shifting perspectives. Overall, participants supported virtual formats, while clinicians remained divided. Objective 3: When compared to virtual formats there were no differences between in-person and virtual/hybrid for pain, quality of life, or self-efficacy. Compared to in-person formats, the virtual format resulted in statistically, but not clinically, lower function scores, and the hybrid format resulted in statistically and clinically fewer chair stand repetitions. Conclusion: Despite limited guidance available on implementation, virtual and hybrid OAMP appear both accepted and generally effective for participants.