Good Life with Osteoarthritis in Denmark (GLA:D®®)
Clinical guidelines for treatment of osteoarthritis (OA) recommend a combined approach consisting of patient education, exercise and weight loss, if needed. In spite of this, the uptake of these elements as first line treatment for patients with painful knee and hip OA was suboptimal in clinical practice.
Good Life with Osteoarthritis in Denmark (GLA:D®®) is a not-for-profit initiative launched by a research team at the University of Southern Denmark in 2013 with the aim of implementing guidelines for the treatment of knee and hip OA in clinical practice in order to facilitate evidence-based, high-quality care of patients with OA. Based on the work of a multi-professional steering group and in close dialogue with referring GPs, orthopedic surgeons, patients and the health care region of Southern Denmark, the GLA:D® initiative has induced a paradigm shift towards early treatment through a bottom-up approach and helped put the management of a chronic disease into a new, cost-effective framework.
GLA:D® program and results
GLA:D® is a standardised, but individualised, treatment plan consisting of two patient education sessions and 12 neuromuscular exercise therapy sessions supervised by a certified clinician. A national electronic database collects the data from patient-reported and functional outcomes and helps ensure that treatment decisions are based on outcomes that patients care most about. Following GLA:D® treatment, sick leave is reduced, one of three people stops taking paracetamol, non-steroidal anti-inflammatory drugs and opioids for knee/hip pain, and pain decreases by 25% on average. Patients also walk 10% faster, experience improved function, quality of life and physical activity level. And results are largely sustained at 1 year. Over 90% of the patients are ‘satisfied’ or ‘very satisfied’ with GLA:D ® after having completed the program. By improving patient outcomes for equal or lower costs, GLA:D® has added value for the patient as well as the healthcare system.
Five years after inception, more than 1200 clinicians have been certified in Denmark. These clinicians offer the program to more than 400 clinics nationwide and have treated nearly 40,000 patients. Patient and clinician feedback, together with emerging evidence in the research field, facilitates and backs up the growing success of GLA:D®.
GLA:D® goes international
GLA:D® has been adapted to different healthcare systems and rolled out in Canada, Australia and China, contributing to value-based healthcare across the world. Spanning four continents, the GLA:D® initiative may help maximize patient value by shifting health resources away from low-value treatments for the great majority of patients not needing a joint replacement.