MOSAICS - Management of Osteoarthritis In Consultations Study

Chief Investigator:

Principal Investigator:

Study Co-ordinator:

Mrs Kris Clarkson

Funder name / reference number: National Institute of Health Research (NIHR) Programme grant for Applied Research ((PGfAR) / RP-PG-0407- 10386) MREC No.: 10/H1017/76
UKCRN Study portfolio: Reference No 10104
Year May 2011 - November 2012, and April 2012 and December 2013.

Study design

The MOSAICS study is a mixed methods study with a nested cluster Randomised Controlled Trial (RCT), based in eight general practices (four intervention and four control), to investigate the feasibility, acceptability and impact of implementing a new approach to supporting self-management for OA in primary care; the Model OA Consultation (MOAC) intervention, developed according to a defined theoretical framework (the WISE model).

The MOSAICS study has two separate parts: a population survey that took place between May 2011 and February 2012 and a cluster randomised trial that recruited between April 2012 and  December 2013.

The Study Protocol has been published - Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care - the Management of OsteoArthritis In Consultations (MOSAICS) study protocol. Implementation Science 2014, 9:95 (27 August 2014).

The MOSAICS study has two separate parts: a population survey that took place between May 2011 and February 2012 and a cluster randomised trial that recruited between April 2012 and  December 2013.

Primary objective

The primary aim of this study is to determine the clinical and cost effectiveness of a model OA consultation (MOAC), implementing the core recommendations from the NICE OA Guidelines in primary care.

Secondary aims are to investigate the impact, feasibility and acceptability of the MOAC intervention; to develop and evaluate a training package for management of OA by general practitioners (GPs) and practice nurses; test the feasibility of deriving “quality markers” of OA management using a new consultation template and medical record review; and describe the uptake of core NICE OA recommendations in participants aged 45 years and over with joint pain.

Interventions

1.   The cluster randomised controlled trial: A cluster RCT conducted in 8 general practices. Four practices received the MOAC intervention to train their GPs and practice nurses to deliver supported self-management through a model OA consultation; four continued to provide usual care.

2.   Population survey: Collection of self-reported cross-sectional data from adults aged 45 years and over identified as having joint pain, particularly their behaviour relating to the NICE core recommendations.

3.   Consultation template and medical record review: Collection of anonymised consultation data and practice level Quality Indicators for management of OA.

4.   Evaluation of the MOAC intervention and the training: Evaluation of the impact, acceptability and feasibility of the MOAC intervention and training using a variety of methods including questionnaires, semi-structured interviews, focus groups and observation (audio and video).