Blended care in patients with knee and/or hip osteoarthritis in physical therapy: a Delphi study on needs and preconditions

Introduction Osteoarthritis is a major public health concern. Despite existing evidence-based treatment options, the health care situation remains unsatisfactory. Digital care options, especially combined with in-person sessions seems to be promising. Therefore, the aim of this study was to investigate the needs, preconditions, barriers and facilitators of blended physical therapy. Methods This Delphi study consisted of interviews, an online survey and focus groups. Participants were physical therapists, patients with hip or knee osteoarthritis with or without experience in digital care and stakeholders of the health care system. In the first phase, interviews were conducted with patients and physical therapists. The interview guide was based on the “Consolidated Framework For Implementation Research”. The interviews focused on experiences with digital and blended care. Furthermore, needs, facilitators and barriers were discussed. In the second phase, an online survey and focus groups served the process to confirm the needs and collect preconditions. Results Nine physical therapists, seven patients and six stakeholders confirm that an increase of acceptance of digital care by physical therapists and patients is crucial. One of the most frequently mentioned facilitator was conducting regular in-person sessions. Physical therapists and patients conclude that blended physical therapy needs to be tailored to the patients’ needs. The reimbursement of blended physical therapy needs to be clarified. Discussion Most importantly, it is necessary to strengthen the acceptance of patients and physical therapists towards digital care. Overall, for development and implementation purposes, it is crucial to take the needs and preconditions into account.