Barriers and Facilitators in the Implementation of Digital, Blended, and Analog Evidence-Based Osteoarthritis Care: International Qualitative Expert Interview Study.
5 affiliations
- 1Digital Health, Department of Human Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, Witten, 58455, Germany, 0049 2302 926 ext 708.
- 2Institute of General Practice and Family Medicine (AM RUB), Medical Faculty, Ruhr University Bochum, Bochum, Germany.
- 3Didactics and Educational Research in Health Science, Department of Human Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany.
- 4Health Services Research, Institute for Diversity Medicine, Medical Faculty, Ruhr University Bochum, Bochum, Germany.
- 5Institute for Diversity Medicine, Medical Faculty, Ruhr University Bochum, Bochum, Germany.
Abstract
Background
Evidence-based nonsurgical osteoarthritis (OA) care programs improve patient outcomes and may reduce the burden of disease. Despite their demonstrated effectiveness, their implementation into routine health care remains limited across health care systems. Understanding factors that facilitate or hinder implementation is essential to support broader adoption and long-term sustainability worldwide.Objective
This study aimed to explore factors that facilitate or hinder the implementation of evidence-based nonsurgical OA care programs. Specifically, it examined implementation across different health care settings, implementation phases, and analog, digital, and blended care models to identify transferable insights for implementation in different national and regional contexts.Methods
We conducted a qualitative expert interview study with 12 international experts involved in evidence-based OA care programs implemented across 6 countries. Semistructured interviews explored experiences with program development, implementation, and further development of analog, digital, and blended care models. Interview transcripts were analyzed using qualitative content analysis according to Kuckartz, using deductive and inductive category development.Results
Key barriers included limited funding and reimbursement structures, insufficient political support, organizational complexity, and legal or regulatory requirements. Important facilitators comprised strong leadership, interdisciplinary collaboration, structured communication, adaptation to local health care contexts, and the use of existing international program structures. Participants further emphasized that implementation requirements varied across the preparation, initial implementation, and consolidation phases, highlighting the need for phase-specific implementation strategies.Conclusions
Successful implementation of evidence-based nonsurgical OA care programs requires sustainable funding, stakeholder engagement, context-specific adaptation, and structured implementation planning across all implementation phases. Existing international program structures and collaboration may facilitate implementation across health care systems while reducing development efforts. Future implementation initiatives should consider phase-specific requirements and local contextual factors to improve long-term adoption and sustainability.
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BibTeX
@article{busse2026barriers,
title = {{Barriers and Facilitators in the Implementation of Digital, Blended, and Analog Evidence-Based Osteoarthritis Care: International Qualitative Expert Interview Study.}},
author = {Theresa Sophie Busse and Julia Nitsche and Ina Carola Otte and Nino Chikhradze and Barbara Jömann and Horst Christian Vollmar and Jennifer Bosompem},
journal = {JMIR rehabilitation and assistive technologies},
year = {2026},
month = oct,
doi = {10.2196/85941},
url = {https://europepmc.org/article/MED/42913401},
note = {CC BY},
}
RIS
TY - JOUR
TI - Barriers and Facilitators in the Implementation of Digital, Blended, and Analog Evidence-Based Osteoarthritis Care: International Qualitative Expert Interview Study.
AU - Theresa Sophie Busse
AU - Julia Nitsche
AU - Ina Carola Otte
AU - Nino Chikhradze
AU - Barbara Jömann
AU - Horst Christian Vollmar
AU - Jennifer Bosompem
PY - 2026
DA - 2026/10/23
JO - JMIR rehabilitation and assistive technologies
DO - 10.2196/85941
UR - https://europepmc.org/article/MED/42913401
AB - Background Evidence-based nonsurgical osteoarthritis (OA) care programs improve patient outcomes and may reduce the burden of disease. Despite their demonstrated effectiveness, their implementation into routine health care remains limited across health care systems. Understanding factors that facilitate or hinder implementation is essential to support broader adoption and long-term sustainability worldwide.Objective This study aimed to explore factors that facilitate or hinder the implementation of evidence-based nonsurgical OA care programs. Specifically, it examined implementation across different health care settings, implementation phases, and analog, digital, and blended care models to identify transferable insights for implementation in different national and regional contexts.Methods We conducted a qualitative expert interview study with 12 international experts involved in evidence-based OA care programs implemented across 6 countries. Semistructured interviews explored experiences with program development, implementation, and further development of analog, digital, and blended care models. Interview transcripts were analyzed using qualitative content analysis according to Kuckartz, using deductive and inductive category development.Results Key barriers included limited funding and reimbursement structures, insufficient political support, organizational complexity, and legal or regulatory requirements. Important facilitators comprised strong leadership, interdisciplinary collaboration, structured communication, adaptation to local health care contexts, and the use of existing international program structures. Participants further emphasized that implementation requirements varied across the preparation, initial implementation, and consolidation phases, highlighting the need for phase-specific implementation strategies.Conclusions Successful implementation of evidence-based nonsurgical OA care programs requires sustainable funding, stakeholder engagement, context-specific adaptation, and structured implementation planning across all implementation phases. Existing international program structures and collaboration may facilitate implementation across health care systems while reducing development efforts. Future implementation initiatives should consider phase-specific requirements and local contextual factors to improve long-term adoption and sustainability.
SN - 2369-2529
ER -