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Alternative Role of Physiotherapists in Improving Access to Total Joint Replacement

This research aims to evaluate a new model of care in orthopaedics using physiotherapists to i) triage hip and knee patients to surgery and ii) provide arthritis management support for patients not yet needing total joint replacement (TJR). Access to care for arthritis, especially waiting times for TJR is a major concern in Canada. With the aging of the population and the concomitant increase in arthritis in Canada, the demand for orthopaedic services such as TJR is expected to increase. One way to reduce wait times for orthopaedic surgery is to improve the efficiency of patient flow through the system. This new model of care aims to streamline patients to the appropriate care and has the opportunity to improve access to non-pharmacologic interventions such as exercise and education.

This research will measure the impact of the physiotherapist’s triage role in increasing the efficiency of patient flow through the system; examine characteristics of, and previous arthritis care of, surgical and non-surgical patients; document patient satisfaction with the triage process; and for non-surgical patients, investigate the acceptability and feasibility of an intervention for support of patients referred to but not needing TJR.

To meet the objectives, the researchers are recruiting patients with hip and knee problems attending orthopaedic clinics. Patients complete standard questionnaires about their level of function, how they manage their arthritis, their confidence in managing their condition and their satisfaction with care in the clinic. A structured telephone interview for non-surgical patients is conducted 6 weeks after the consultation in the orthopaedic clinic to learn more about patients’ arthritis management strategies and further information needs. Other data on waiting times and clinic processes are also being collected. The results of this study will add to our understanding of the impact of this model of care and provide us with valuable information on how to improve care for patients.

This project is funded through the Canadian Institutes of Health Research (CIHR).

Researchers: Crystal MacKay, Dr. Elizabeth Badley (PI), Dr. Aileen Davis, Dr. Nizar Mahomed