Osteoarthritis

IMPACT-TAS is a project led by Associate Professor Dawn Aitken from the Menzies Institute for Medical Research. It aims to improve osteoarthritis care in Tasmania and reduce the need for joint replacement surgery.

“The Collaboration has enabled important stakeholder consultation and involvement during the project’s development, including with the Tasmanian Health Service and Primary Health Tasmania.

Exposure through TCHI’S networks continues to build awareness and momentum which is facilitating engagement and funding support. Importantly, having TCHI’s support has created a level of confidence and buy-in which is helping to attract/engage additional partner support.”

Associate Professor Dawn Aitken – Project Lead, IMPACT-TAS

Tasmania has the longest public wait times in the country for joint replacement surgery, with some patients waiting up to four years.

The most common reason for this kind of surgery? Osteoarthritis. And it’s prevalent in Tasmania due to an older population, greater socio-economic disadvantage, and higher obesity rates compared to the rest of Australia.

Tasmania also has the highest rate of opioid prescriptions for osteoarthritis pain per capita in the country (source: Australian Atlas of Healthcare Variation).

While exercise is the best treatment, it’s underused in Tasmania and other parts of Australia and the world.

Dawn and her team are using a program called GLA:D®- an evidence-based program first developed in Denmark proven to reduce pain, increase physical activity and function, and improve quality of life for patients. GLA:D® has been shown to delay or prevent the need for surgery in 3 out of 4 patients.

By referring patients to exercise-based care instead of surgery, improving access to care, and using group-based physiotherapy programs like GLA:D®, it’s likely we’ll see more efficient and effective services, fewer hospital consultations and significant health system savings.

IMPACT-TAS is a public private partnership. Every stage of development and design has been driven by engagement and collaboration with clinicians, policy makers, consumers, partner organisations and researchers.

This research will help people in Tasmania who have knee and hip osteoarthritis. They will receive affordable and effective care that doesn’t require surgery. This leads to better health outcomes and better osteoarthritis management across the state.

Uptake of GLA:D® so far in Australia has been mostly in the private sector. It’s expensive and most private health insurers cover only a small portion, leaving patients out-of-pocket or unable to access the program.

This project aims to expand the public offerings of GLA:D® in Tasmania. The team have partnered with the Tasmanian Health Service to implement GLA:D® in primary care settings across the State.

In 2021 the team began offering GLA:D® at two community outpatient clinics – Kingston Health Centre and Clarence Integrated Care Centre. For the first time in Tasmania, this is providing publicly funded access to GLA:D®.

The team will continue to expand GLA:D® across Tasmania, including in the North and North West.

IMPACT-TAS has sub-projects, which are helping to improve osteoarthritis care in Tasmania. These include:

• Training more physiotherapists and exercise physiologists to become GLA:D® accredited
• Establishing a Tasmanian GLA:D® Consumer Network
• Raising awareness of GLA:D® and non-surgical osteoarthritis management in Tasmania
• Co-designing, implementing and evaluating an intervention in general practice to increase GP referrals to GLA:D® (and exercise generally for osteoarthritis)
• Co-designing, implementing and evaluating a telehealth version of GLA:D® for rural and remote areas in Tasmania

The project findings could help change government policies to make it easier for people to access GLA:D® and other allied health programs in Australia.

Once GLA:D® is more widely available in the state, Primary Health Tasmania will help to launch it officially by adding it to their new eReferral system.

The team are now working with translational research scientists to come up with ways to develop, implement and evaluate strategies to best share their research findings with stakeholders, including policy-makers.

Program branding, social media campaigns and connecting with the broader media will help raise awareness of the program.

Dawn hopes the research will show the cost-benefit of making GLA:D® more widely available to the public, so that more people living with osteoarthritis can experience better quality of life without needing surgery.

The IMPACT-Tas research team have successfully secured further funding for Strategies to scale-up and sustain a first-line treatment approach to managing knee and hip osteoarthritis in Tasmania.

This new proposal aims to improve access to GLA:D®, a physiotherapy program for people with osteoarthritis living in rural and remote areas of Tasmania.

Dawn and her team will develop a publicly funded telehealth version of GLA:D® and evaluate its effectiveness.

The proposal will also provide in-person training for Tasmanian healthcare professionals to become certified in GLA:D® and create a network of Tasmanian GLA:D® consumers for information sharing and support.

The research team have been working closely with consumers and clinicians including GPs, surgeons, rheumatologists and physiotherapists. They work closely with health organisations including the Tasmanian Health Service, Primary Health Tasmania, Health Consumers Tasmania, Arthritis & Osteoporosis Tasmania, RACGP Tasmania, the Australian Physiotherapy Association, and Royal Flying Doctors Service Tasmania.

The goal is to improve the health outcomes and quality of life for those with osteoarthritis in Tasmania and avoid the need for knee and hip replacement surgery.