Usefulness, efficacy, and satisfaction with a web-based integrated clinical pathway for patients with knee cartilage damage with emphasis on an online exercise program
Project code: L7-50184
Tender: Public call for (co)financing of research projects for 2023
Leading partner: University of Novo mesto Faculty of Health Sciences
Partner: University of Novo mesto Faculty of Economics and Informatics
Total value of the project: 300,186.00 EUR (the volume is coordinated with the valid price of the full-time equivalent for the individual year)
Funding information: The project is co-financed by the Slovenian Research and Innovation Agency (ARIS) from the state budget and co-financier Artros, d.o.o.
Start: 1. October 2023
End: 30. September 2026
Project manager: Prof. Karmen Erjavec, PhD
Contact person: Prof. Karmen Erjavec, PhD, karmen.erjavec@uni-nm.si, +386 7 393 00 21
Project description:
The project addresses several challenges of modern society. It: 1) investigates the treatment of patients with knee cartilage damage (injuries and osteoarthritis), which are among the most common musculoskeletal conditions in developed countries; 2) introduces an integrated clinical pathway (ICP) that enables person-centered, multidisciplinary, and multi-organizational treatment of the patient; 3) supports the digital and green transition strategy; 4) includes an interdisciplinary approach to increase adherence in the implementation of online health programs. Thus, the object of the study (online ICP for patients with knee cartilage defects with a focus on the online exercise program) will be extensively studied, including:
- interdisciplinarity: communication, information technology and health perspective,
- quantitative and qualitative approach involving key stakeholders (patients and health professionals) and application of a descriptive cross-sectional study and a prospective observational study,
- upgrade of the existing project (ARRS, L7-2631-3824-2020).
A review of existing studies reveals several research problems: a lack of research on 1) the course and quality of existing treatment offered to patients with knee cartilage damage, 2) perceptions of a web-based application focused on an online exercise program, 3) an evaluation of the acceptability and quality of the web-based program prototype and 4) effectiveness of an online exercise program with communication support and the use of rating scales (WOMAC and KOOS).
Therefore, the aim is to explore the basis and create a prototype of the online ICP for patients with knee cartilage damage, focusing on the online exercise program and its implementation, where we will achieve a comprehensive view through an interdisciplinary approach and the use of qualitative and quantitative methodology, as well as the inclusion of patients' and health professionals' perspectives.
Objectives:
- to determine the opinions of patients and medical professionals about the course and quality of existing treatment offered to patients with knee cartilage damage,
- to determine patients' and health professionals' opinions about the involvement of different stakeholders in ICP for patients with knee cartilage damage,
- determine patients' and health professionals' perceptions of the online ICP, which guides patients in managing various risk factors related to maintaining knee joint function (for health care consultation and disease self-management) and also includes an online exercise program for patients with knee cartilage damage, concluding with the inclusion of appropriate communication methods to motivate regular independent exercise according to age and other specific patient groups,
- create an ICP prototype with an emphasis on an online exercise program for patients with knee cartilage damage, which includes communication between the patient and medical staff to discuss and individualize the exercise program,
- to evaluate the effectiveness of the prototype online program for independent management of symptoms of cartilage damage in the knee joint (WOMAC, KOOS and VAS rating scales),
- to determine the opinions of patients and medical professionals about the acceptance, satisfaction, reasons for interruption of independent training, and possibility of improvement of the prototype.
Work packages:
- WP1: Analysis of the existing literature and evaluation of the ethical relevance of the research
Objective: Forming the groundwork for conducting research.
- WP2: Setting the groundwork for an integrated clinical pathway for patients with knee cartilage defects with an emphasis on an online exercise program
Objectives:
1) Ascertain the views of patients and healthcare professionals on the course and quality of existing treatment for patients with knee cartilage defects (knee cartilage damage and knee OA)
2) Identify the views of patients and healthcare professionals on the involvement of different stakeholders in an integrated clinical pathway for patients with knee cartilage defects (knee cartilage damage and knee OA);
3) Identify the perceptions (desires, needs, and expectations) of patients and health professionals regarding the online integrated clinical pathway, with an emphasis on an online exercise program for patients with knee cartilage damage, incorporating appropriate communication methods for motivating regular independent exercise according to age and other specific patient groups;
4) Evaluate a prototype of an online integrated clinical pathway with an emphasis on an online exercise program.
- WP3: Prototype production of an online integrated clinical pathway focusing on an online exercise program
Objective: To create a prototype integrated clinical pathway focused on an online exercise program for patients with knee cartilage defects that includes patient communication with medical staff to discuss and individualize the exercise program.
- WP4: Evaluating the effectiveness of using an online exercise program
Objective: To evaluate the effectiveness of a prototype online program for the self-management of symptoms of knee cartilage defects (cartilage damage and knee OA) using the WOMAC, KOOS, and VAS rating scales.
- WP5: Evaluating the acceptability, satisfaction, and potential for improvement of a prototype online integrated clinical pathway focused on an online exercise program
Objective: To optimize the user experience, we will seek to determine patients' and healthcare professionals' opinions on acceptance, satisfaction with the use of the online ICP with the online exercise program, the causes of discontinuity and ways to improve the prototype online integrated clinical pathway for patients with knee cartilage damage with an emphasis on an online exercise program.
- WP6: Concept for an online integrated clinical pathway with emphasis on an online exercise program (created based on prototype improvements)
Objective: Conceptualization of prototype improvements.
- WP7: Dissemination
Objective: To inform the scientific, professional and general public about the project and its results.
Main project results:
- a report containing the results of the literature review;
- a baseline report for an integrated clinical pathway for patients with cartilage impairment with a focus on an online exercise program;
- a report on the need for referral of program participants to other stakeholders within the integrated clinical pathway;
- a prototype of online integrated clinical pathway with an emphasis on an online exercise program;
- a report on the acceptability, quality, causes of discontinuity of independent exercise, and opportunities for improvement of the prototype online integrated clinical pathway with an emphasis on an online exercise program;
- a concept report on an online integrated clinical pathway with a focus on an online exercise program (created based on improvements to the prototype);
- at least one scientific article.
Activities: