AktivA – Active living with knee or hip osteoarthritis
The AktivA model was initiated in 2015 and based on similar models in Sweden (BOA) and Denmark (GLAD) (see links below). AktivA is a national model in Norway of implementation of evidence-based guidelines for first-line treatment of patients with hip and knee osteoarthritis, including degenerative meniscus tear. All patients should go through first-line treatment in the primary health care before referral to specialist health care. The AktivA is based at Oslo University Hospital, Division of Orthopedic Surgery. The overall aim of AktivA is to reach all patients in Norway with knee and/or hip osteoarthritis and offer evidence-based first-line treatment regardless of where they live.
What is AktivA?
The AktivA model consists of three parts; 1. An education course for physiotherapist. 2. A patient education program (an osteoarthritis school) and a supervised, individually tailored exercise program of 6-12 weeks. 3. The AktivA Quality Registry. See also video “Hva er Aktiva” (in Norwegian).
The education course for physiotherapist; a one-day course which includes a) an update on evidence-based knowledge and clinical practice guidelines for patients with knee and/or hip osteoarthritis (also including those with degenerative meniscal tear), b) standardized functional tests and validated questionnaires used in the AktivA Quality Registry and c) login and information about the AktivA Quality Registry. The AktivA Quality Registry is based on electronic signed consent and includes automatically generated patient reported questionnaires at baseline, 3 months 1 and 2 years, as well as a data entered by the physiotherapist at baseline and 3 months. At 3 months a report is generated including graphs based on the patient reported questionnaires and the physical functional tests undertaken at baseline and 3 months. This report can be included in the medical record, serve as a good basis for communication on functional status, and serve as a referral note. The AktivA Quality Registry automatically generates links to questionnaires 1 and 2 years after inclusion date.
Patients can be referred to AktivA by general practitioners, specialists or by personal contact. Patients can find the closest AktivA physiotherapist to where they live by looking at the interactive map on the web site (www.aktivmedartrose.no), “Finn AktivA-klinikk”. The patients will attend a patient education program (an osteoarthritis school) and a supervised, individually tailored exercise program of 6-12 weeks, with the aim of future self-management, but with the possibility of booster sessions with their physiotherapists. At inclusion and at 3 months, 1 and 2 years, the patients will answer questions about their pain, symptoms, physical function, physical activity level and quality of life. They receive an e-mail at each follow-up time including a link to the questionnaires in the AktivA Quality Registry.
By October 2021 more than 1500 physiotherapists from all health regions in Norway have attended the educational one-day program, and more than 9000 patients have registered in the AktivA quality registry (www.aktivmedartrose.no ).
The Nordic collaboration
The AktivA model is based on similar models in:
- Sweden (BOA registry: https://boa.registercentrum.se/ )
- Denmark (GLA:D®: https://www.glaid.dk/english.html).
All these three national models in Scandinavia have reported significant reduced pain, improved function, physical activity level and health-related quality of life.