# Implementation research on osteoarthritis in Asia: a systematic review

## TL;DR

This paper reviews how osteoarthritis interventions are implemented in Asia, finding limited high-quality studies and highlighting barriers like cultural practices and resource constraints.

## Contribution

The study systematically reviews osteoarthritis implementation research in Asia, identifying gaps and barriers specific to the region.

## Key findings

- Only seven high-quality studies on osteoarthritis implementation were found in Asia.
- Key barriers include socio-cultural practices, resource constraints, and healthcare system limitations.
- Implementation outcomes varied widely across studies, with moderate to high reporting quality.

## Abstract

Osteoarthritis is a prevalent musculoskeletal disorder significantly impacting quality of life, especially in ageing populations. While effective interventions exist, their implementation in Asian healthcare settings is often lacking. This study aims to assess and collate existing evidence on implementation research related to osteoarthritis in Asia.

A systematic and comprehensive search was performed across EMBASE, MEDLINE, Scopus, Web of Science, CINAHL, ScienceDirect, ProQuest, Google Scholar, and Shodhganga, adhering to PRISMA 2020 guidelines. This search was limited to English-language studies. Studies published from 2004 to 2024 focusing on OA implementation research within Asian populations were included. Three reviewers independently performed study selection, data extraction, and quality assessment using the StaRI checklist. A narrative synthesis summarises the findings.

Of 2,365 records identified, seven studies met the inclusion criteria. These studies, conducted across diverse Asian settings, primarily evaluated educational and community-based interventions for osteoarthritis that explicitly reported implementation processes or outcomes. Although reporting quality was generally moderate to high, the studies demonstrated substantial heterogeneity in implementation outcomes, including adherence, fidelity, acceptability, adoption, and effectiveness. Key barriers to implementation included socio-cultural practices, resource constraints, and limitations within healthcare systems.

The scarcity of high-quality implementation studies highlights a significant gap in translating osteoarthritis evidence into practice across Asia. Future research must prioritise context-specific, scalable strategies, standardise outcome measures, and proactively address socio-cultural barriers to optimise osteoarthritis management for the diverse Asian populations.

Prospero registration number: CRD42024542237.