The Swedish Osteoarthritis Registry

Better management of patients with OsteoArthritis (BOA) was initiated in 2008. It was a joint project between four geographic regions in Sweden, financed by the national social insurance office and the Swedish government. The aim was to reduce sick leave and improve rehabilitation and it was based on the knowledge that only a minority of all patients who receive surgery because of osteoarthritis have seen a physiotherapist or occupational therapist at any time before surgery. Nevertheless information, physical activity and weight control are core treatments of osteoarthritis according to national as well as international guidelines.

The supported osteoarthritis self-management programme

Since 2010, the BOA Register has been in existence as a National Quality Register, evaluating patient-reported outcomes following an intervention – the Supported Osteoarthritis Self-Management Programme (SOASP). In January 2023 the BOA Register was renamned The Swedish Osteoarthritis Registry. In the SOASP, scientific evidence for information and physical activity in conjunction with osteoarthritis is put into clinical practice. The SOASP is led by a physiotherapist or occupational therapist and in many cases a patient representative. Through the SOASP, patients acquire knowledge that will allow them to make their own decisions regarding their health as well as support to change their lifestyle and by doing so promote better health. Early intervention in conjunction with osteoarthritis, before the problems become too serious, represents the greatest opportunity to prevent functional disability and deterioration in health. The hope is that the patients will contact a physiotherapist or occupational therapist directly with their joint problems. Only a small proportion of patients do so at present although the trend is moving in the right direction. The SOASP can from May 2019 be delivered as a group intervention, and individual intervention, a complete digital intervention or a combination of digital and physical intervention.

195 000 patients have participated

From the start of the project in 2008 until November 2022, approximately 195 000 patients have used the SOASP. Between 2008 and 2018 3500 physiotherapists and occupational therapists were trained to hold the Supported Osteoarthritis Self-Management Programme and today SOASP is offered in 1100 units all over Sweden. In several places throughout the country the SOASP has become routine in the healthcare system and the orthopaedic surgeon returns patient referrals if the patient has not met a physiotherapist for basic treatment. The SOASP is now included in several care programmes for patients with osteoarthritis of the hip and knee. All county councils/regions have included the SOASP and The Swedish Osteoarthritis Registry in the care choice procurement process.

Improving health care quality

The aim of The Swedish Osteoarthritis Registry is that patients with osteoarthritis must be dealt with equally and optimally during their initial contact with the healthcare system, regardless of where that contact takes place. The aim is to improve health-related quality of life and the level of physical activity in patients with osteoarthritis, primarily in the hip and knee, and to reduce healthcare consumption and sick leave due to osteoarthritis. Furthermore, The Swedish Osteoarthritis Registry aims to improve quality within physiotherapeutic work through systematic evaluation, open comparison, and feedback of results. Each unit that reports data to the register can at any time access their results in real time and compare them with the national average.

Patient cooperation

Patient collaboration includes concrete collaboration with the Swedish Rheumatism Association and with representatives for those patients who make up the target group for the Supported Osteoarthritis Self-Management Programme (SOASP). The work being done by the The Swedish Osteoarthritis Registry has also attracted international interest. The Registry has sister projects in Denmark and Norway and is part of an international network of countries that are working actively to implement evidence-based guidelines in healthcare.