Evidence map›Paper›PMID 41029682›Full record

Trial reportBMC musculoskeletal disorders2025

Collaborative model of care between orthopaedics and allied health professionals in knee osteoarthritis (CONNACT): process evaluation of an effectiveness-implementation hybrid randomized control trial.

Bryan Yijia Tan, Eugene Yong Sheng Woon, Su-Yin Yang, Konstadina Griva, Soren T Skou, David Hunter, Andrew M Briggs, Julian Thumboo, Josip Car

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Bryan Yijia TanWoodlands Health, Singapore, Singapore.
Eugene Yong Sheng WoonWoodlands Health, Singapore, Singapore. woon0038@e.ntu.edu.sg.
Su-Yin YangWoodlands Health, Singapore, Singapore.
Konstadina GrivaLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Soren T SkouUniversity of Southern Denmark, Odense, Denmark.
David HunterThe University of Sydney, Sydney, Australia.
Andrew M BriggsCurtin University, Perth, Australia.
Julian ThumbooSingapore General Hospital, Singapore, Singapore.
Josip CarKing's College London, London, England.

Funding

TTSH Community Fund, Ng Teng Fong Healthcare Innovation Programme NTF_JUL2017_I_C2_CQR_01
6 · The paper itself

Abstract

objectiveTo evaluate the implementation process of a community-based, multidisciplinary intervention (CONNACT) through a randomized controlled trial (RCT) in order to contextualize the RCT outcomes and inform implementation opportunities.

methodsThis study is an embedded qualitative process evaluation of the CONNACT effective-implementation hybrid RCT. Semi-structured interviews with 22 intervention patients and 14 healthcare professionals were conducted. Interviews were audio-recorded, transcribed and translated using framework analysis. Data was analysed thematically and the emergent themes were organised into the conceptual domains of RE-AIM. An explanatory sequential methods approach was used to discuss the Reach and Effectiveness domains of RE-AIM, whereby quantitative data (i.e. recruitment logs and published quantitative results) was discussed in relation to this study's qualitative data.

resultsReach: 55.4% of the patients who met the inclusion criteria participated, while work or family commitments and disinterest in physiotherapy are the primary reasons for declining participation. EFFECTIVENESS: CONNACT intervention is not superior to control hospital-based usual care in terms of pain, function, and quality of life, but superior in physical performance, knee satisfaction, global perceived effect and positive dietary change. The results and effectiveness of CONNACT are presented and discussed in a related publication. Adoption: Healthcare professionals proposed changes for long-term sustainability (transdisciplinary approach, expert patients) despite their strong support for CONNACT. Implementation (context): A spectrum of passive-resigned and impatient-unrealistic mindsets, pain beliefs, and expectations was elucidated. Implementation (mechanism of impact): Focus on patient education and empowerment encouraged patients to actively accept their condition and practice self-efficacy. Although group classes are a source of support, motivation, and positive peer pressure, several patients preferred personalized treatments. CONNACT's synergistic nature benefitted patients who are more complex. Maintenance (patient-level): Patients highlighted the importance of incorporating exercise into their regular routines, but lack of time and inertia remain as significant barriers.

conclusionThe themes have allowed a better understanding of the RCT primary and secondary outcomes and informed the next phase of implementation. CONNACT and similar interventions should identify and address reasons for refusing participation [Reach]; improve group classes with initial evaluations, equal attention paid to patients, tailored exercises, and acknowledge progress [Effectiveness, Implementation]; and adopt a streamlined resource-efficient transdisciplinary design [Maintenance].

trial registrationThis study, which primarily employs qualitative methods for data collection, is not a clinical trial (clinical trial number: not applicable). Ethics approval (NHG DSRB ref no: 2020/00067;) was obtained before commencement of this study.

Indexed as

Allied Health PersonnelOrthopedicsOsteoarthritis, KneePatient Care TeamAgedFemaleHumansMaleMiddle AgedQualitative ResearchHybrid trialImplementationKnee osteoarthritisMixed methodsProcess evaluation

Identifiers

PMID41029682
PMCPMC12487322

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.