MOSAICS research project

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).

 

MOSAICS Publications

The following is a detailed overview of the MOSAICS project.

Dziedzic KS, Healey EL, PorcheretMet al. (Implementing OA guidelines) 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 27;9:95.

Blackburn S, Higginbottom A, Taylor R, Bird J, Østerås N, Hagen K, Edwards JJ, Jordan K, Jinks C, Dziedzic K. 2016. Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care. Research Involvement and Engagement. doi>full text>

Finney A, Healey E, Jordan JL, Ryan S, Dziedzic KS. 2016. Multidisciplinary approaches to managing osteoarthritis in multiple joint sites: a systematic review. BMC musculoskeletal disorders, vol. 17(1), 266. doi> full text>

Edwards JJ, Khanna M, Jordan KP, Jordan JL, Bedson J, Dziedzic KS. 2015. Quality indicators for the primary care of osteoarthritis: a systematic review. Ann Rheum Dis, vol. 74(3), 490-498. link> doi> full text>

Edwards JJ, Jordan KP, Peat G, Bedson J, Croft PR, Hay EM, Dziedzic KS. 2015. Quality of care for OA: the effect of a point-of-care consultation recording template. RHEUMATOLOGY, vol. 54(5), 844-853. link> doi> full text>

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, 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

Porcheret M, Main C, Croft P, McKinley R, Hassell A, Dziedzic K. 2014. Development of a behaviour change intervention: a case study on the practical application of theory.IMPLEMENTATION SCIENCE, vol. 9, Article ARTN 42. link> doi> full text>

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

Ong BN, Morden A, Brooks L, Porcheret M, Edwards JJ, Sanders T, Jinks C, Dziedzic K. 2014. Changing policy and practice: Making sense of national guidelines for osteoarthritis.SOCIAL SCIENCE & MEDICINE, vol. 106, 101-109. link> doi>

Finney AG, Porcheret M, Grime J, Handy J, Jordan K, Jester R, Dziedzic K. Defining the content of an opportunistic osteoarthritis consultation with health care professionals:A Delphi consensus study. Annals of Rheumatic Disease (vol. 70, p. 756). doi>

Porcheret M, Grime J, Main C, Dziedzic K. 2013. Developing a model osteoarthritis consultation: a Delphi consensus exercise. BMC Musculoskelet Disord, vol. 14, 25. link> doi>