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SAMBA: Integrated model improves quality of care for hip/knee OA
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LIVERPOOL, England — An integrated care model marked by regular communication between general practitioners, orthopedic surgeons, and physical therapists yielded improved patient outcomes in a cohort of Norwegian patients, according to findings presented here.
Nina Osteras, MD, of Diakonhjemmet Hospital in Oslo, Norway, suggested that communication is often poor between clinicians managing patients. “People with hip or knee OA don’t always get treatments that are recommended in the guidelines,” she said. “The SAMBA study is a multidisciplinary collaboration.”
The approach was a structured pathway that emphasized the role of the general practitioner, according to Osteras. General practitioners were instructed to explain diagnoses and treatment alternatives, including exercise and a healthy eating component, to patients who desired to lose weight.
“Our hypothesis was that SAMBA [model] would result in better quality of care, including more referrals to physical therapy, and more discharge notes from physical therapists,” Osteras said.
The study was conducted from January 2015 through June 2016. The researchers accrued 393 patients from six municipalities around Oslo. The analysis also included 40 of 80 invited general practitioners and 37 of 60 invited physical therapists who attended the workshops. Osteras reported that participating physical therapists initiated 27 OA patient education and exercise groups. Each municipality initiated the intervention in a step-wise fashion each month, and after 6 months all six municipalities were participating.
Nearly 300 patients (n = 284) received the intervention, and 109 acted as controls. Osteras noted that 75% of the participants in the control group were women. Otherwise, the groups were comparable in terms of age, BMI, comorbidities, education, pain and other factors.
Results showed that quality of care improved from 39% to 60% in the intervention group, compared with an improvement from 37% to 41% for controls.
Patients in the intervention group also were more likely to be referred to physical therapy than controls at 3 months’ follow-up (OR = 2.1; 95% CI, 1.1-4.1). Patient satisfaction also was higher in the intervention group compared with controls (P < .001), as was the proportion of patients with improved physical activity (OR = 14.1; P < .001) at 6 months’ follow-up.
“A tailor-made strategy to implement the SAMBA model resulted in improved quality of care,” Osteras concluded. “The strategy increased desired events.” – by Rob Volansky
Reference:
Osteras N, et al. Abstract #48. Presented at: OARSI 2018 World Congress on Osteoarthritis; April 26-29, 2018; Liverpool, England.
Disclosure: Osteras reports no relevant financial disclosures.