Advanced Practice Physiotherapists and the implementation of the JIGSAW-E model for the management of osteoarthritis in Scottish primary care settings: A qualitative case study

Helen Frost, Tricia Tooman, Julie Cowie, Nicola Gillespie , Phil Ackerman, Emer Krievs, Krysia Dziedzic

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objective
To explore the acceptability, barriers and enablers of NICE guidelines for osteoarthritis in the Scottish primary care setting using the Joint Implementation of Guidelines for Osteoarthritis in Western Europe (JIGSAW-E) model and investigate the role of Advanced Physiotherapy Practitioners (APPs) in providing evidence-based care.

Design
A qualitative case study comprised of semi-structured interviews followed by a workshop with participants.

Setting
10 Scottish primary care practices.

Participants
Six general practitioners (GPs) and eight APPs were interviewed. Twenty-three practitioners attended the workshop including 22 physiotherapists and one GP.

Results
While both GPs and APPs recognised the need to improve and standardise osteoarthritis care delivery, this study found that APPs were better situated to implement the evidence-based model. Barriers to implementation included lack of time for training, limited appointment time for GPs to consult and discuss medication use with patients, limitation of disease specific guidelines for patients with complex multimorbidity, and system-based barriers such as electronic data collection and high staff turnover. The key enabler was practitioners’ motivation to provide optimal, standardised quality care for osteoarthritis. To increase acceptance, ownership and usability for both practitioners and patients, the JIGSAW-E model materials required adaptation to the local context.

Conclusion
This study provides evidence that the JIGSAW-E model is acceptable in Scottish primary care. Furthermore, the evolving roles of GPs and APPs within multidisciplinary primary care teams provides a platform to implement the JIGSAW model, where APPs are well placed to provide leadership and training in the delivery of evidence-based care for osteoarthritis.
Original languageEnglish
Pages (from-to)81-88
JournalPhysiotherapy
Volume117
Early online date30 Aug 2022
DOIs
Publication statusPublished - 1 Dec 2022

Keywords / Materials (for Non-textual outputs)

  • Advanced Practice Physiotherapy,
  • Osteoarthritis, Guidelines Implementation

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