# Impact of a Consumer e-Learning Course on Beliefs, Treatment Choices, and Outcomes Among People With Hip and Knee Osteoarthritis: Qualitative Interview Study

## TL;DR

A free online course helped people with hip or knee osteoarthritis better understand their condition, leading to more positive attitudes and proactive management.

## Contribution

A novel e-learning course was developed and shown to reshape beliefs and improve self-management in people with osteoarthritis.

## Key findings

- Participants reshaped their beliefs and attitudes toward osteoarthritis and its management.
- The course supported learning and shifts in beliefs, leading to a more positive mindset.
- Participants adopted a proactive approach to managing their condition.

## Abstract

First-line management for hip and knee osteoarthritis includes lifestyle treatments, such as exercise and weight loss (if appropriate), whereas joint replacement surgery is recommended only for severe symptoms after these options have been exhausted. However, many people with osteoarthritis hold misconceptions about the condition, leading to lower acceptance of nonsurgical treatments, such as exercise, and the mistaken belief that surgery is their only option. Novel patient education approaches that address these misconceptions are recommended to improve uptake of lifestyle treatments, reduce unnecessary surgery, and improve outcomes for people with osteoarthritis. We developed a 4-week self-directed consumer e-learning course on osteoarthritis management. In a randomized controlled trial, using the course led to immediate and sustained improvements in osteoarthritis knowledge. However, participants’ perspectives on the course and an understanding of how it impacted osteoarthritis beliefs, treatment choices, and outcomes were unknown.

This study aims to explore how an e-learning course for people with hip and knee osteoarthritis may have impacted their osteoarthritis beliefs, treatment choices, and outcomes.

In this qualitative study, we conducted semistructured individual interviews (N=20) with randomized controlled trial participants with hip or knee osteoarthritis who accessed a 4-week consumer e-learning course on osteoarthritis and its management. Interviews were audio recorded, transcribed verbatim, and thematically analyzed following a framework approach, which was guided by the common sense model of self-regulation.

Four themes were developed from the interviews: (1) participants reshaped their beliefs and attitudes toward osteoarthritis and its management, (2) participants adopted a proactive approach to management, (3) participants developed a more positive mindset, and (4) the course supported learning and shifts in beliefs.

The e-learning course resulted in shifts in participants’ beliefs and attitudes toward osteoarthritis and its management, increasing their confidence in living with osteoarthritis and resulting in a more optimistic outlook on the future. The e-learning course is freely available and could be a useful resource for people with osteoarthritis to enhance their understanding of the condition and its management.