Implementing a guideline-based model of care for hip and knee osteoarthritis in Finland (FIN-OA): Protocol for a benchmarking-controlled trial

Objective: Osteoarthritis is a growing global health challenge, driven by ageing populations and rising obesity rates. The condition incurs significant costs due to diagnostics, treatments and indirect impacts like absenteeism. Although guidelines recommend education, exercise and weight management as first-line treatments, adherence among healthcare professionals and patients varies. This project aims to assess the current state of osteoarthritis care in Finland and implement and evaluate a guideline-based model of care for hip and knee osteoarthritis by integrating the Good Life with osteoArthritis from Denmark (GLA:D®) programme into local care pathways. It also seeks to promote evidence-based knowledge nationwide. Design: This hybrid, type-3 benchmarking-controlled implementation trial is conducted in primary healthcare across two Wellbeing Services Counties in Finland. The study includes three phases. 1. Pre-implementation – Surveying current care using registry data (6 years), patient and professional questionnaires, and interviews. Developing a model of care (MoC) and implementation intervention based on research informed theories and models. 2. Implementation – Integrating and refining the new MoC, and training physiotherapists. 3. Evaluation – Assessing implementation (primary outcome: intervention fidelity, the proportion of eligible care according to the new care pathway) and health-economic outcomes (healthcare utilization and costs at 1, 3, and 5 years compared to pre-implementation data), as well as patient-reported outcomes at 3 months and 1, 3 and 10 years. Discussion: This project aims to bridge the gap between guidelines and practice, improve outcomes, reduce costs, and ensure equitable care. Results will guide future strategies and may be adapted across Finland. Trial registration: ClinicalTrials.gov, 263/13.00.04.00/2025.