Joint Implementation of Guidelines for oSteoArthritis in Western Europe (JIGSAW-E)

Osteoarthritis (OA) is a leading cause of joint pain and years lived with disability worldwide. OA causes considerable detrimental impact on patients’ daily activities and quality of life. People with OA desire high quality care, support and information about OA. The internationally recognised UK National Institute of Health and Care Excellence (NICE) recommends that core treatments such as written information and advice on exercises and physical activity should be offered to all people with osteoarthritis. However, research has shown that the quality of primary care management of OA varies greatly.

NICE recommends that core treatments such as written information and advice on exercises and physical activity should be offered to all people with symptomatic osteoarthritis.  This represents quality care for people with OA.


Overall ambition

The overall ambition is to implement a model osteoarthritis (OA) consultation and quality indicators of OA care, informed by internationally recognised NICE OA recommendations, to support self-management in adults aged 45 years and over in seven European regions (UK, the Netherlands, Norway, Denmark, Portugal, France and Scotland). This is being achieved through the systematic implementation of previously piloted innovations in the West Midlands (JIGSAW)

This project supports healthcare professionals to proactively support patients with self-management of OA, in line with NICE Quality Standards (launched June 2015).

JIGSAW-E is part of a linked series of projects starting from research (MOSAICS) through local implementation of innovations (JIGSAW) to international pilots (JIGSAW-E)


JIGSAW/E Publications

Smith RD, Dziedzic KS, Quicke JG, Holden MA, McHugh GA, Healey EL, Identification and evaluation of self-reported physical activity instruments in adults with osteoarthritis: A systematic review. Arthritis Care Res (Hoboken). 2018 Oct 15. Click here

Healey EL, Afolabi EK, Lewis M, Edwards JJ, Jordan KP, Finney A, Jinks C, Hay EM, Dziedzic KS. Uptake of the NICE osteoarthritis guidelines in primary care: a survey of older adults with joint pain. BMC Musculoskelet Disord. 2018 Aug  17; Click here

Hay E, Dziedzic K, Foster N, Peat G, van der Windt D, Bartlam B, Blagojevic-Bucknall M, Edwards J, Healey E, Holden M, Hughes R, Jinks C, Jordan K, Jowett S, Lewis M, Mallen C, Morden A, Nicholls E, Ong BN, Porcheret M, Wulff J, Kigozi J, Oppong R, Paskins Z, Croft P. Optimal primary care management of clinical osteoarthritis and joint pain in older people: a mixed-methods programme of systematic reviews, observational and qualitative studies, and randomised controlled trials. Southampton (UK): NIHR Journals Library; 2018 Jul.
Click here

Dziedzic KS, Allen KD. Challenges and controversies of complex interventions in osteoarthritis management: recognizing inappropriate and discordant care. Rheumatology (Oxford). 2018 May 1;57(suppl_4):iv88-iv98. Click here

Barnett LA, Pritchard MG, Edwards JJ, Afolabi EK, Jordan KP, Healey EL, Finney AG, Chew-Graham CA, Mallen CD, Dziedzic KS. Relationship of anxiety with joint pain and its management: A population survey. Musculoskeletal Care. 2018 Sep;16  Click here

Oppong R, Jowett S, Lewis M, Clarkson K, Paskins Z, Croft P, Edwards JJ, Healey E, Jordan KP, Morden A, Ong BN, Porcheret M, Finney A, Hay E, Dziedzic K. Cost-effectiveness of a model consultation to support self-management in patients with osteoarthritis. Rheumatology (Oxford). 2018 Jun. Click here

Porcheret M, Main C, Croft P, Dziedzic K. Enhancing delivery of osteoarthritis care in the general practice consultation: evaluation of a behaviour change intervention. BMC Fam Pract. 2018 Feb 6 Click here

Jackson H, Barnett LA, Jordan KP, Dziedzic KS, Cottrell E, Finney AG, Paskins Z, Edwards JJ. Patterns of routine primary care for osteoarthritis in the UK: a cross-sectional electronic health records study. BMJ Open. 2017 Dec 29. Click here

Finney A, Dziedzic KS, Lewis M, Healey E. Multisite peripheral joint pain: a cross-sectional study of prevalence and impact on general health, quality of life, pain intensity and consultation behaviour. BMC Musculoskelet Disord. 2017 Dec 16. Click here

Dziedzic KS, Healey EL, Porcheret M, Afolabi EK, Lewis M, Morden A, Jinks C, McHugh GA, Ryan S, Finney A, Main C, Edwards JJ, Paskins Z, Pushpa-Rajah A, Hay EM. Implementing core NICE guidelines for osteoarthritis in primary care with a model consultation (MOSAICS): a cluster randomised controlled trial. Osteoarthritis Cartilage. 2018 Jan;26 Click here

Jordan KP, Edwards JJ, Porcheret M, Healey EL, Jinks C, Bedson J, Clarkson K, Hay EM, Dziedzic KS. Effect of a model consultation informed by guidelines on recorded quality of care of osteoarthritis (MOSAICS): a cluster randomised controlled trial in primary care. Osteoarthritis Cartilage. 2017 Click here

Healey EL, Main CJ, Ryan S, McHugh GA, Porcheret M, Finney AG, Morden A, Dziedzic KS. A nurse-led clinic for patients consulting with osteoarthritis in general practice: development and impact of training in a cluster randomised controlled trial. BMC Fam Pract. 2016 Dec 21;17(1):173 Click here

Allen KD, Choong PF, Davis AM, Dowsey MM, Dziedzic KS, Emery C, Hunter DJ, Losina E, Page AE, Roos EM, Skou ST, Thorstensson CA, van der Esch M, Whittaker JL. Osteoarthritis: Models for appropriate care across the disease continuum. Best Pract Res Clin Rheumatol. Click here

Dziedzic KS, French S, Davis AM, Geelhoed E, Porcheret M. Implementation of musculoskeletal Models of Care in primary care settings: Theory, practice, evaluation and outcomes for musculoskeletal health in high-income economies. Best Pract Res Clin Rheumatol. 2016 Jun;30(3):375-397. Click here

Finney A, Healey E, Jordan JL, Ryan S, Dziedzic KS. Multidisciplinary approaches to managing osteoarthritis in multiple joint sites: a systematic review. BMC Musculoskelet Disord. 2016 Jul 8;17:266. Click here

Blackburn S, Higginbottom A, Taylor R, Bird J, Østerås N, Hagen KB, Edwards JJ, Jordan KP, Jinks C, Dziedzic K. Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care. Res Involv Engagem. 2016 Mar 17;2:5. Click here

Morden A, Brooks L, Jinks C, Porcheret M, Ong BN, Dziedzic K. Research “push”, long term-change, and general practice. J Health Organ Manag. 2015;29(7):798-821. Click here

Østerås N, Jordan KP, Clausen B, Cordeiro C, Dziedzic K, Edwards J, Grønhaug G, Higginbottom A, Lund H, Pacheco G, Pais S, Hagen KB. Self-reported quality care for knee osteoarthritis: comparisons across Denmark, Norway, Portugal and the UK. RMD Open. 2015 Oct 20;1(1):e000136. Click here

Morden A, Ong BN, Brooks L, Jinks C, Porcheret M, Edwards JJ, Dziedzic KS. Introducing Evidence Through Research “Push”: Using Theory and Qualitative Methods. Qual Health Res. 2015 Nov;25(11):1560-75. Click here

Morden A, Jinks C, Ong BN, Porcheret M, Dziedzic KS. Acceptability of a ‘guidebook’ for the management of Osteoarthritis: a qualitative study of patient and clinician’s perspectives. BMC Musculoskelet Disord. 2014 Dec 13;15:427. Click here

Edwards JJ, Jordan KP, Peat G, Bedson J, Croft PR, Hay EM, Dziedzic KS. Quality of care for OA: the effect of a point-of-care consultation recording template. Rheumatology (Oxford). 2015 May;54(5):844-53. Click here

Dziedzic KS, Healey EL, Porcheret M, Ong BN, Main CJ, Jordan KP, Lewis M, Edwards JJ, Jinks C, Morden A, McHugh GA, Ryan S, Finney A, Jowett S, Oppong R, Afolabi E, Pushpa-Rajah A, Handy J, Clarkson K, Mason E, Whitehurst T, Hughes RW, Croft PR, Hay EM. 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. Implement Sci. 2014 Aug 27;9:95. Click here

Porcheret M, Main C, Croft P, McKinley R, Hassell A, Dziedzic K. Development of a behaviour change intervention: a case study on the practical application of theory. Implement Sci. 2014 Apr 3;9(1):42. Click here

Ong BN, Morden A, Brooks L, Porcheret M, Edwards JJ, Sanders T, Jinks C, Dziedzic K. Changing policy and practice: making sense of national guidelines for osteoarthritis. Soc Sci Med. 2014 Apr;106:101-9. Click here

Edwards JJ, Khanna M, Jordan KP, Jordan JL, Bedson J, Dziedzic KS. Quality indicators for the primary care of osteoarthritis: a systematic review. Ann Rheum Dis. 2015 Mar;74(3):490-8. Click here

Dziedzic KS, Healey EL, Main CJ. Implementing the NICE osteoarthritis guidelines in primary care: a role for practice nurses. Musculoskeletal Care. 2013 Mar;11(1):1-2. Click here

Porcheret M, Grime J, Main C, Dziedzic K. Developing a model osteoarthritis consultation: a Delphi consensus exercise. BMC Musculoskelet Disord. 2013 Jan 16;14:25. doi: 10.1186/1471-2474-14-25. PubMed PMID: 23320630; PubMed Central PMCID: PMC3560189. Click here

Finney A, Porcheret M, Grime J, Jordan KP, Handy J, Healey E, Ryan S, Jester R, Dziedzic K. Defining the content of an opportunistic osteoarthritis consultation with primary health care professionals: a Delphi consensus study. Arthritis Care Res (Hoboken). 2013 Jun;65(6):962-8. Click here

Porcheret M, Healey E, Dziedzic KS. Uptake of best arthritis practice in primary care–no quick fixes. J Rheumatol. 2011 May;38(5):791-3. Click here

Dziedzic KS, Hill JC, Porcheret M, Croft PR. New models for primary care are needed for osteoarthritis. Phys Ther. 2009 Dec;89(12):1371-8. Click here

Grime J, Dudley B. Developing written information on osteoarthritis for patients: facilitating user involvement by exposure to qualitative research. Health Expect. 2014 Apr;17(2):164-73. Click here

Wathall S, Stevenson K, Duffy H, Edwards J, Cooper V, Porcheret M, Dziedzic K. The Implementation of STarT BACK and an OA e-template: Utilising Existing GP Electronic Clinical Systems to Manage Patients with Low Back Pain or Osteoarthritis during a Routine Consultation. Second West Midlands Health Informatics Network Conference (WIN 2017). January 2016 https://wmhin.org/wp-content/uploads/2016/02/wathall_Startback-and-OA-template_WIN2016.pdf

Dziedzic K, Bierma Zeinstra S, Vliet Vlieland T, Roos EM, Skou ST, Hagen KB, Osteras
N, Pais S, Cordeiro C, Duffy H, Hughes R. Joint Implementation of Guidelines for oSteoArthritis in Western Europe: JIGSAW-E Physiotherapy. 2016; 102S: eS138. [The 4th European Congress of the ER WCPT]

Schiphol D, Vliet Vlieland TP, van Ingen R, Peter WF, Meesters JJ, de Wit MP, van de Boogaard JN, Krol J, Buitelaar H, Evans N, Bierma-¬Zeinstra SM, Dziedzic KS. Joint Implementation of Guidelines for oSteoArthritis in Western Europe: JIGSAW¬E in progress in the Netherlands. Osteoarthritis and Cartilage. 2017; 25: S414. [OARSI 2017]

Quicke J, Rimmer Y, Beasley J, White N, Stevenson K, Duffy H, Evans N, Dziedzic K. Implementing Osteoarthritis Clinical Guidelines Amongst UK Physiotherapists. World Congress of Physiotherapy, Cape Town South Africa 2017

Egerton T, Diamond LE, Buchbinder R, Bennell KL, Slade SC. A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians’ barriers and enablers to the management of osteoarthritis. Osteoarthritis Cartilage. 2017;25(5):625-38. Click here

Finney AG, Lambourne H, Cottrell E (2019) Osteoarthritis management in primary care. Practice Nursing 30 (3) 114-118

Campbell.L, JIGSAW-E Patient Champions, S. Blackburn, J. Meesters, M. De Wit, D. Schiphof, T. Vliet Vlieland, S. Bierma-Zeinstra, N. Østerås , S. Pais, E. Roos, N. Evans, K. Dziedzic, A PARTNERSHIP IN IMPLEMENTATION: ADAPTING AN OSTEOARTHRITIS GUIDEBOOK ACROSS EUROPEAN CULTURES – WITH PATIENTS, FOR PATIENTS’ Click here

S Blackburn, J Meesters, M De Wit, L Campbell, C Rhodes, D Schiphof, T Vliet Vlieland, S Bierma-Zeinstra, N Østerås, S Pais, E Roos, N Evans, K Dziedzic: ‘Improving care for patients with osteoarthritis in five european countries: the jigsaw-e patient panel’ Click here