The effect of geographic location and payor type on provincial-wide delivery of the GLA:D program for hip and knee osteoarthritis in Alberta, Canada

C Allyson Jones; Geneviève Jessiman-Perreault; Ania Anna Kania-Richmond; Amy Metcalfe; David A Hart; Lauren A Beaupre; Bone and Joint Health SCN

doi:10.1016/j.ocarto.2023.100398

The effect of geographic location and payor type on provincial-wide delivery of the GLA:D program for hip and knee osteoarthritis in Alberta, Canada

Osteoarthr Cartil Open. 2023 Aug 15;5(4):100398. doi: 10.1016/j.ocarto.2023.100398. eCollection 2023 Dec.

Authors

C Allyson Jones^{1

2}, Geneviève Jessiman-Perreault¹, Ania Anna Kania-Richmond^{1

3}, Amy Metcalfe^{3

4}, David A Hart^{1

5}, Lauren A Beaupre^{1

2}; Bone and Joint Health SCN

Affiliations

¹ Bone and Joint Health Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada.
² Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
³ Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
⁴ Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
⁵ Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Abstract

Objective: The Good Life with osteoArthritis: Denmark (GLA:D™) program for knee and hip osteoarthritis has been shown to be effective, but evaluations have yet to explore whether effectiveness differs by program context. The present study explores whether there are differences in effectiveness of the GLA:D™ program for treatment of hip and knee osteoarthritis across program location (i.e., rural, urban, metro) and program payor (i.e., public, private) within Alberta, Canada.

Design: The study population was adults with hip or knee osteoarthritis attending the 8-week GLA:D™ supervised exercise and education programme in Alberta between Sep 2017-Mar 2020. Outcomes of interest were joint-related pain and quality of life (HOOS/KOOS), health quality of life (EQ-5D-5L), and performance-based functional (30-s chair stand test; 40-m walk test) measures. Minimally clinically important changes were calculated for each outcome and ANOVA and chi-square tests were used to determine statistical significance by program location or payor.

Results: Of the 1321 eligible participants, 974 (73.7%) completed the baseline questionnaire, about 50% of participants participated in a metro area and 60% paid privately for the program. There were no statistically significant differences in improvements of joint-related pain, joint-related quality of life, health-related quality of life, or performance-based functional measures by program location or program payor, except for participants who received the program in a publicly covered primary care clinic who experienced significantly larger improvements in joint-related pain.

Conclusion: The implementation of the GLA:D™ program for the treatment of knee and hip osteoarthritis in Alberta is effective across a range of contexts.

Keywords: Effectiveness; Exercise; Osteoarthritis; Private healthcare; Public healthcare; Rural; Urban.