As part of a replication study after the randomized controlled trial (RCTs) in the Netherlands, the impact was assessed on health services utilization and expenditure of two self-management programmes for older adults with osteoarthritis (OA) of the knee and hip.

Evidence-based patient education and exercise programmes, developed and tested in RCTs, are often insufficiently diffused among practitioners and primary healthcare providers and tend to have a modest reach in the population. Large-scale adoption in primary healthcare can be improved if programmes are feasible and effective in real life.

The programmes were conducted in real-life conditions by primary healthcare providers (local health centres, home-care providers, physical therapy centres). Pre-test/post-test data were collected for consultation of the general practitioner (GP), medical specialist, physical therapist, and for the use of OA medication, as well as for the expenditure for physical therapy and OA medication.

In total, 20 Knee and 20 Hip programmes were carried out by 18 providers. The Knee programmes were attended by 204 participants and the Hip programmes by 169 participants. Physical therapy and use of OA medication for both programmes and consultation of the medical specialist for the Hip programme decreased. No effect was observed for consultations of the GP. Expenditure for physical therapy and use of OA medication could not be assessed, due to difficulties to obtain sufficient reliable data from participating health insurers. Both programmes produced similar outcomes in real-life conditions compared to their RCTs. The implications are discussed as to accurate data collection on OA expenditure, future cost-utility and cost-effectiveness studies, and the large-scale implementation of the programmes in the Dutch primary healthcare system.