Babatunde, O.O. orcid.org/0000-0002-5064-6446, Adetunji, O. orcid.org/0000-0002-3474-0029, Alonge, I. orcid.org/0000-0003-3679-0836 et al. (7 more authors) (2025) Process and feasibility of implementing guideline recommendations for the care of osteoarthritis in West Africa. BMJ Global Health, 10 (6). e018714. ISSN 2059-7908
Abstract
Objectives
To assess the feasibility of a guideline-informed model of care for osteoarthritis in primary healthcare and community pharmacy settings in the West African context.
Methods
The 4-phase mixed-methods programme of research undertaken in Southwest Nigeria, West Africa. Phases 1–2 involved contextual adaptation of guideline-informed care—Joint Implementation of Guidelines for OSteoArthritis in West-Africa (JIGSAW-A): (1) focus groups (n=4) with patients, community pharmacists and healthcare professionals (HCPs) to identify patient preferences and support needs of HCPs; (2) stakeholders resource contextualisation/codesign (ie, osteoarthritis guidebook in local languages, HCPs training/support package). Iterative codesign workshops (n=3) using participatory approaches, model osteoarthritis consultation simulations and consensus agreement.
Phase 3: following training and a 12-week pilot implementation period, patient-reported quality of care was assessed by the OsteoArthritis Quality Indicator questionnaire (modified 9-item scale 0%–100%, 100%=best), and implementation of the JIGSAW-A model of care was evaluated using the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. Patient and HCP interviews explored barriers and facilitators, usefulness and acceptability. In phase 4, recommendations for further scale-up and wider implementation of integrated osteoarthritis care were specified.
Results
Phases 1–2 highlight the burden and impact of everyday living with joint pain and misinformation which affects help-seeking. Participants expressed the need for a broad information and education campaign and access to self-management support, which informed iterative contextualisation of osteoarthritis care and patient information resources used to support pilot implementation in phase 3.
Over 12 weeks, 12 HCPs (community pharmacies, physiotherapists and doctors) were involved in evaluation across nine sites. Of 369 patient consultations that were reported, high rates of quality indicator achievement were found for self-management advice (97%), topical analgesic use (89%) and exercise recommendations (87%). Compliance with full patient assessment in line with the protocol was poor (17%).
Conclusions
We found that evidence-based care for osteoarthritis, involving community pharmacies (as a usual first point of call) and other primary care clinicians, is feasible and may improve aspects of care in low-resource settings. Further research is needed to ascertain long-term sustainability and cost-effectiveness.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2025. Re- use permitted under CC BY - https://creativecommons.org/licenses/by/4.0/ |
Keywords: | Humans; Osteoarthritis; Focus Groups; Feasibility Studies; Adult; Aged; Middle Aged; Primary Health Care; Nigeria; Female; Male; Practice Guidelines as Topic |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 30 Jun 2025 15:39 |
Last Modified: | 30 Jun 2025 15:39 |
Status: | Published |
Publisher: | BMJ |
Refereed: | Yes |
Identification Number: | 10.1136/bmjgh-2024-018714 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:228550 |