D. Malarvizhi1, D. Anandhi1, J. Suresh1, D. Mercy Joy1, T. S. Veeragoudhaman1, P. Maheshwari2, C. Srikesavan3
1SRM Institute of Science and Technology, SRM College of Physiotherapy, Kattankulathur, India, 2Padmashree Institute of Physiotherapy, Physiotherapy, Bengaluru, India, 3University of Oxford, Nuffield Department of Orthopaedics and Musculoskeletal Sciences, Oxford, United Kingdom
Background: Osteoarthritis knee (OA knee) is a highly prevalent chronic joint condition associated with pain, disability and reduced quality of life. Guidelines recommend self-management, patient education, weight loss advice, behavioural support and tailored exercise and physical activity as main non-pharmacological treatment components. The overall purpose of this research programme is to implement a physiotherapist-led complex intervention involving these components to improve clinical outcomes in people with knee OA of Tamil Nadu state (Population 76.5 million), India.
Purpose: The present study forms part of the wider programme and aims to develop and evaluate an OA knee patient education booklet in Tamil, and explore perspectives of patients, carers, and physiotherapists on receiving or delivering the complex intervention.
Methods: A patient education booklet was developed in an iterative process involving a needs assessment, review of evidence, and input from physiotherapists and patient representatives. The booklet covered clinical aspects of OA knee, self-management strategies, exercise illustrations, advice on physical activity, and frequently asked questions and answers.
50 adults with OA knee, their carers, and physiotherapists were recruited to provide feedback. A questionnaire survey was used in Likert format on readability, comprehensibility, appropriateness, perceived usefulness, design and layout, and continued usage intention. Additional questions focused on possible barriers and enablers to delivery of the complex intervention.
50 adults with OA knee, their carers, and physiotherapists were recruited to provide feedback. A questionnaire survey was used in Likert format on readability, comprehensibility, appropriateness, perceived usefulness, design and layout, and continued usage intention. Additional questions focused on possible barriers and enablers to delivery of the complex intervention.
Results: Between August 2021 and January 2022, 21 adults with OA knee (4 males; 17 females; average age 59 years), 14 carers (7 males; 7 females; average age 50.3 years), and 15 physiotherapists (7 males; 8 females; average 18 years of work experience) participated. Of people with knee OA, 62% (13/21) were retired or unemployed and 52% (11/21) had a monthly income less than 10,000 Indian rupees (approximately £108 or $125).
The majority of participants (49/50, 98%) reported that they fully read the booklet. The booklet was easy to read and understand. The information was found useful and relevant. All agreed that they would recommend it to others and continue to use it in the future. A final version was produced based on the feedback such as modifying the exercise illustrations more culturally-relevant to the Tamil population.
All participants perceived the complex intervention as useful. 57% (12/21) of people with knee OA felt challenged to attend multiple treatment sessions. The frequently reported barriers were lack of time, family responsibilities, comorbidities, and travel costs. Improved pain and knee function, self-management skills, and reduced usage of staff time and hospital resources if delivered in group-format were considered as enablers. Remote delivery of the complex intervention was a viable option for nearly 50% of the participants. However, lack of digital and technological skills to use Smartphones and Internet were perceived as main barriers.
The majority of participants (49/50, 98%) reported that they fully read the booklet. The booklet was easy to read and understand. The information was found useful and relevant. All agreed that they would recommend it to others and continue to use it in the future. A final version was produced based on the feedback such as modifying the exercise illustrations more culturally-relevant to the Tamil population.
All participants perceived the complex intervention as useful. 57% (12/21) of people with knee OA felt challenged to attend multiple treatment sessions. The frequently reported barriers were lack of time, family responsibilities, comorbidities, and travel costs. Improved pain and knee function, self-management skills, and reduced usage of staff time and hospital resources if delivered in group-format were considered as enablers. Remote delivery of the complex intervention was a viable option for nearly 50% of the participants. However, lack of digital and technological skills to use Smartphones and Internet were perceived as main barriers.
Conclusions: Our Tamil OA knee education booklet was deemed useful and acceptable. Our findings provide insight into finding solutions for possible challenges to future delivery of the complex intervention.
Implications: We followed a structured approach in producing an evidence-informed OA knee patient education booklet in Tamil. Our future research will inform applying the complex intervention in outpatient physiotherapy settings.
Funding acknowledgements: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Keywords:
Knee osteoarthritis
Complex intervention
Patient education
Knee osteoarthritis
Complex intervention
Patient education
Topics:
Research methodology, knowledge translation & implementation science
Musculoskeletal: lower limb
Disability & rehabilitation
Research methodology, knowledge translation & implementation science
Musculoskeletal: lower limb
Disability & rehabilitation
Did this work require ethics approval? Yes
Institution: SRM Medical College Hospital and Research Centre
Committee: Institutional Ethics Committee
Ethics number: 2842/IEC/2021
All authors, affiliations and abstracts have been published as submitted.
