title: Improving access to better care for people with knee and/or hip pain: service evaluation of allied health professional-led primary care.
abstract: Chronic knee and hip pain is prevalent, impairing mobility, function and quality of life. Allied health professions (AHPs) are better trained and have more time than general practitioners in primary care to advise and support people to adopt healthier lifestyles (maintain healthy weight, increase physical activity) that reduce joint pain. We evaluated whether AHP-led primary care delivering person-centred, practical lifestyle coaching was a feasible, effective way to manage chronic knee and/or hip pain.
  
  
  
  At initial assessment the 'Joint Pain Advisor' assessed pain, function, quality of life, physical activity, waist circumference and body mass, taught simple self-management strategies and used behaviour change techniques (motivational interviewing, goal setting, action/coping planning) to alter participants' lifestyles. Participants were invited for 6-week and 6-month reviews, when the Advisor reassessed clinical outcomes, fed back progress and reinforced health messages. Feasibility and effectiveness of the service was evaluated using quantitative and qualitative methods.
  
  
  
  Uptake of the service was good: 498 people used the service. Between initial assessment and reviews, participants' pain, function, quality of life, weight, waist circumference and physical activity improved (p < 0.005). Service user satisfaction was high; they reported easier access to advice and support tailored to their needs that translated into clinical benefits and a more efficient pathway reducing unnecessary consultations and investigations. Relatively few people returned for a 6-month review as they considered they had received sufficient advice.
  
  
  
  AHP-led care is a popular, effective, efficient and sustainable way to manage joint pain, without compromising safety or quality of care.
authors.affiliation: St George's, University of London and Kingston University, UK.|Health Innovation Network, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Walker
authors.affiliation: Lewisham NHS Clinical Commissioning Group, UK.
authors.forename: R
authors.initials: R
authors.lastname: Williams
authors.affiliation: Health Innovation Network, London, UK.
authors.forename: F
authors.initials: F
authors.lastname: Sibley
authors.affiliation: Lewisham and Greenwich NHS Trust, UK.
authors.forename: D
authors.initials: D
authors.lastname: Stamp
authors.affiliation: Health Innovation Network, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Carter
authors.affiliation: St George's, University of London and Kingston University, UK.|Health Innovation Network, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Hurley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000488:Allied Health Personnel; D018771:Arthralgia / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000628:therapy*; D017060:Patient Satisfaction; D011320:Primary Health Care
keywords: hip; joint pain advisor; knee pain; primary care