title: Osteoarthritis guidelines: Barriers to implementation and solutions.
abstract: Osteoarthritis (OA) is a leading cause of disability worldwide. Clinical practice guidelines (CPGs) have been developed to facilitate improved OA management. Scientific communities worldwide have proposed CPGs for OA treatment. Despite the number of highly prominent guidelines available and their remarkable consistency, their uptake has been suboptimal. Possibly because of the multitude of barriers related to the implementation of CPGs. For example, different guidelines show contradictions, some lack evidence, and they lack a hierarchy or tools to facilitate their translation and application. Also, the guidelines do not acknowledge the effect of comorbidities on choosing the treatments. Finally, poor integration of multidisciplinary services within and across healthcare settings is a major barrier to the effective implementation of management guidelines. Here we describe the main problems related to the OA guidelines and some solutions so as to offer some guidance on the elaboration of future CPGs and their implementation in primary care.
authors.affiliation: Department of Physiotherapy, Occupational Therapy and Speech Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Royal North Shore Hospital, Rheumatology Department, and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ferreira de Meneses
authors.affiliation: Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, hôpital Cochin, University Paris Descartes, PRES Sorbonne Paris Cité, Assistance publique-Hôpitaux de Paris, Paris, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Rannou
authors.affiliation: Royal North Shore Hospital, Rheumatology Department, and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia. Electronic address: david.hunter@sydney.edu.au.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hunter
mesh_terms: D019468:Disease Management; D006284:Health Plan Implementation / Q000592:standards*; D006801:Humans; D010003:Osteoarthritis / Q000628:therapy*; D010348:Patient Care Team / Q000592:standards; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards
keywords: Clinical practice guidelines; Implementation; Osteoarthritis