Barriers and facilitators to implementing core osteoarthritis treatments in China: a mixed-method study
Objective To understand current practices and identify barriers and facilitators to implementing guideline-recommended core osteoarthritis (OA) treatments in China.Design An exploratory mixed-methods designSetting Public and private clinical institutions across mainland China.Participants A total of...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/8/e100546.full |
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| author | Guoxin Ni Ziru Wang Shuning Duan Xier Chen Huili Deng Yunqi Wang |
| author_facet | Guoxin Ni Ziru Wang Shuning Duan Xier Chen Huili Deng Yunqi Wang |
| author_sort | Guoxin Ni |
| collection | DOAJ |
| description | Objective To understand current practices and identify barriers and facilitators to implementing guideline-recommended core osteoarthritis (OA) treatments in China.Design An exploratory mixed-methods designSetting Public and private clinical institutions across mainland China.Participants A total of 498 healthcare professionals participated. The qualitative phase included semistructured interviews (n=15) and a qualitative survey (n=181). The quantitative phase consisted of a survey with 302 respondents across 19 provinces, representing seven health professions.Results Five themes identified as barriers during the qualitative phase: misconceptions about OA; limitations in current medical insurance policies; insufficient multidisciplinary collaboration; lack of workplace support and low patient adherence to self-management. Three themes identified as facilitators: telehealth and community-based delivery pathways; professional training and patient education resources; and personalised services with positive feedback. Quantitative findings showed that physical agent therapy (56%) and traditional Chinese medicine (22%) were the most frequently used OA treatments, while exercise therapy was implemented in only 9% of cases. The average OA knowledge score was 31.2 (±8.9) out of 55, with the lowest self-rated confidence in interdisciplinary collaboration (3.4±0.1, ‘somewhat confident’). The most applicable factors impacting the implementation of core OA treatments included patient comorbidities, knowledge of pain science and exercise therapy, and financial support (all 2.8±0.8, ‘applicable’).Conclusions The uptake of core OA treatments in China remains suboptimal, constrained by limitations in insurance coverage, workforce capacity and interdisciplinary integration. Enhancing telehealth accessibility, strengthening professional training and refining policy incentives may help bridge this evidence-practice gap and improve OA management in China. |
| format | Article |
| id | doaj-art-80433c5cc11f4eebb543e64872f50f1f |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-80433c5cc11f4eebb543e64872f50f1f2025-08-22T12:45:12ZengBMJ Publishing GroupBMJ Open2044-60552025-08-0115810.1136/bmjopen-2025-100546Barriers and facilitators to implementing core osteoarthritis treatments in China: a mixed-method studyGuoxin Ni0Ziru Wang1Shuning Duan2Xier Chen3Huili Deng4Yunqi Wang5Department of Rehabilitation Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China1 School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China2 School of Sports Medicine, Wuhan Sports University, Wuhan, Hubei, China2 School of Sports Medicine, Wuhan Sports University, Wuhan, Hubei, China3 School of Medicine, Xiamen University, Xiamen, Fujian, China4 School of Physical Education and Health, Longyan University, Longyan, Fujian, ChinaObjective To understand current practices and identify barriers and facilitators to implementing guideline-recommended core osteoarthritis (OA) treatments in China.Design An exploratory mixed-methods designSetting Public and private clinical institutions across mainland China.Participants A total of 498 healthcare professionals participated. The qualitative phase included semistructured interviews (n=15) and a qualitative survey (n=181). The quantitative phase consisted of a survey with 302 respondents across 19 provinces, representing seven health professions.Results Five themes identified as barriers during the qualitative phase: misconceptions about OA; limitations in current medical insurance policies; insufficient multidisciplinary collaboration; lack of workplace support and low patient adherence to self-management. Three themes identified as facilitators: telehealth and community-based delivery pathways; professional training and patient education resources; and personalised services with positive feedback. Quantitative findings showed that physical agent therapy (56%) and traditional Chinese medicine (22%) were the most frequently used OA treatments, while exercise therapy was implemented in only 9% of cases. The average OA knowledge score was 31.2 (±8.9) out of 55, with the lowest self-rated confidence in interdisciplinary collaboration (3.4±0.1, ‘somewhat confident’). The most applicable factors impacting the implementation of core OA treatments included patient comorbidities, knowledge of pain science and exercise therapy, and financial support (all 2.8±0.8, ‘applicable’).Conclusions The uptake of core OA treatments in China remains suboptimal, constrained by limitations in insurance coverage, workforce capacity and interdisciplinary integration. Enhancing telehealth accessibility, strengthening professional training and refining policy incentives may help bridge this evidence-practice gap and improve OA management in China.https://bmjopen.bmj.com/content/15/8/e100546.full |
| spellingShingle | Guoxin Ni Ziru Wang Shuning Duan Xier Chen Huili Deng Yunqi Wang Barriers and facilitators to implementing core osteoarthritis treatments in China: a mixed-method study BMJ Open |
| title | Barriers and facilitators to implementing core osteoarthritis treatments in China: a mixed-method study |
| title_full | Barriers and facilitators to implementing core osteoarthritis treatments in China: a mixed-method study |
| title_fullStr | Barriers and facilitators to implementing core osteoarthritis treatments in China: a mixed-method study |
| title_full_unstemmed | Barriers and facilitators to implementing core osteoarthritis treatments in China: a mixed-method study |
| title_short | Barriers and facilitators to implementing core osteoarthritis treatments in China: a mixed-method study |
| title_sort | barriers and facilitators to implementing core osteoarthritis treatments in china a mixed method study |
| url | https://bmjopen.bmj.com/content/15/8/e100546.full |
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