Supporting general practitioner Referral of patients with hip and knee osteoarthritis to Evidence-based First linE caRe (REFER)

Osteoarthritis affects approximately 2.2 million Australians, costing the health system $3.5 billion annually. The Royal Australian College of General Practitioners (RACGP) Osteoarthritis Guidelines state all people with hip and knee osteoarthritis should receive first line care of exercise-therapy, education, and weight management (if appropriate) before considering other options such as medication and surgery. However, less than half of people with osteoarthritis currently receive this care.

REFER study

The objective of this project is to evaluate the feasibility of implementing an intervention to increase general practitioner (GP) referral of patients with hip or knee osteoarthritis to physiotherapist led osteoarthritis services.

Further aims are to examine the effect of the intervention on GP awareness of guidelines and evidence surrounding management of osteoarthritis; to assess the clinical effectiveness of GLA:D® in patients (e.g. pain, quality of life, surgery intention) who are referred to the program by their GP; and to conduct an evaluation to refine intervention prior to testing in a larger randomized controlled trial.

Are you interested in participating?

We are recruiting general practice clinics to participate in REFER. If you are a GP, practice nurse, or practice manager and think your practice may be interested in participating please contact us at or complete this short form.

Chief investigators: Dr Allison Ezzat, Associate Professor Christian Barton,  Associate Professor Joanne Kemp, Dr Danilo do Oliveira Silva, Dr Marcella Pazzinatto, Associate Professor Jo-Anne Manski-Nankervis, Ms Marg Thomas.

Research officer: Ms Alison Gibbs.

How can I find out more?


HEC no: HEC21424


Further information about physiotherapist led first line care for hip and knee osteoarthritis:

GLA:D® (Good Life with Arthritis from Denmark) Australia is an evidence-based group education and exercise program for people with hip and knee OA provided by physiotherapists. Visit GLA:D® Australia for further information.

OAHKS (OsteoArthritis Hip and Knee Service) is an assessment and screening service run by advanced practice physiotherapists, aiming to optimize management for patients with hip and knee OA including referral on for surgical opinion if required. Currently, OAHKS are largely located within hospital locations. Visit the OAHKS website for further information.