Including preferences of patients with osteoarthritis into policy interventions


Scientific study title:

Towards a patient-centered system: Integrating preferences of patients with osteoarthritis into evaluation of health services interventions to improve patient outcomes and health system efficiency


Principal Investigator:

Deborah A Marshall, PhD; Professor, Department of Community Health Sciences, Faculty of Medicine, University of Calgary; Arthur JE Child Chair Rheumatology Research


Start and End Date:

April 2019 to March 2025



Why do this research?

Osteoarthritis (OA) is a chronic disease affecting 10-15% of Canada’s population. It causes severe pain and disability, and is the leading cause of joint replacement surgery. Healthcare service planning does not currently consider patient preferences and their impact on health interventions. This could lead to the introduction of programs that patients do not use, which is a waste of system resources. The consideration of patient preferences with uptake of health services and the impact on wait times, patient outcomes and costs are important to inform the design of effective patient-centered health services delivery.


What will be done?

In previous work by our team, we built a model that simulated OA patient flows, healthcare resource use and costs. We will measure individual patient preferences, and include these in the simulation model. Then, we will use the model to evaluate how patient outcomes and system performance changes with new health interventions, taking into account how many patients would choose those interventions.

We will look at two different policies aimed at addressing wait times for surgery. The first is a referral management policy which would give patients information about wait times for different surgeons, and allows them to choose their preferred surgeon or the surgeon with the shortest wait time. The second policy offers patients the choice of an evidence-based conservative medical management program. Our study will look at whether patients would use this alternative program and how this varies based on things like cost. Depending on patient choices, both policies may shorten overall wait times, improve outcomes and reduce costs.


Who is involved? 

Our team of OA clinicians, decision makers, researchers, patients and analysts will ensure our research is clinically meaningful and is translated into patient-centered policy and practice.




Peter Faris, Alberta Health Services; Glen Hazlewood, University of Calgary, Department of Rheumatology; Jean Miller, University of Calgary; Sylvia Teare, University of Calgary; Tom Noseworthy, University of Calgary, Community Health Sciences; Colleen Weeks, University of Alberta; Jason Werle, Alberta Health Services; Claire Barber, University of Calgary, Department of Rheumatology;  Jill Robert, Alberta Health Services; George Tomlinson, University of Toronto, Institute of Health Policy, Management and Evaluation; Eric Bohm, University of Manitoba, Department of Surgery




Kelly Dinsmore, Edmonton Musculoskeletal Centre




Darren Mazzei, University of Calgary


Research Staff: 

Gillian Currie, Karen MacDonald


Funding Agency

Canadian Institutes of Health Research


How do people get involved? 

If you would like more information about this study, please contact:

Gillian R. Currie