Cross-cultural adaptation and implementation of Good Life with osteoarthritis in Denmark (GLA:D™): group education and exercise for hip and knee osteoarthritis is feasible in Canada.
OBJECTIVE
Adapt and evaluate the feasibility of implementing Good Life with osteoArthritis in Denmark (GLA:DTM) in Canada for people with mild to severe hip/knee osteoarthritis.


METHODS
Patients triaged to non-surgical management participated in two education sessions and 12 supervised, neuromuscular exercise classes. We used the RE-AIM implementation framework evaluating outcomes of Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance. Patients completed surveys pre-program and at 3 months follow-up. Program fidelity was evaluated at four observations against a priori criteria. We conducted semi-structured interviews with therapists post-program.


RESULTS
72 patients consented to participate, 59 started the program and one withdrew on physician advice. The remaining 58 provided follow-up data. Mean age was 67 years; 78% were female and 52% had body mass index (BMI) >25. The effect of the program was demonstrated: 40% improvement in pain with 59% achieving a clinically important improvement of ≥2 points on the Numeric Pain Rating scale. Statistically significant improvement also occurred in the Hip disability/Knee injury and Osteoarthritis Outcome Score subscales. 24% reported increased physical activity. Program fidelity was demonstrated with all criteria met. Therapists emphasized that rolling recruitment allowed appropriate supervision and resulted in participants encouraging each other. 99% of participants indicated they benefitted from and were satisfied with the program and 90% reported using the knowledge daily. 52% were willing to pay >$250 Cdn for the program.


CONCLUSION
GLA:DTM implementation was feasible in the Canadian context with results similar to those of >7,000 participants in Denmark. Implementation and evaluation of GLA:DTM Canada is now occurring nationally.
['Davis|A M|AM|', 'Kennedy|D|D|', 'Wong|R|R|', 'Robarts|S|S|', 'Skou|S T|ST|', 'McGlasson|R|R|', 'Li|L C|LC|', 'Roos|E|E|']
D000368:Aged D000369:Aged, 80 and over D002170:Canada D065246:Culturally Competent Care D004185:Disability Evaluation D015444:Exercise D005081:Exercise Therapy D005240:Feasibility Studies D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D015207:Osteoarthritis, Hip D020370:Osteoarthritis, Knee D059408:Pain Management D010147:Pain Measurement D010353:Patient Education as Topic D015397:Program Evaluation
Cross-cultural adaptation Education Hip and knee osteoarthritis Non-surgical management Neuromuscular exercise Implementation feasibility study