A recently published qualitative study in 'Musculoskeletal Care' elucidated that shared decision‐making about lifestyle management without delaying orthopaedic opinion is preferable, and more psychological support may boost participation.

The Lifestyle Management Programme (LMP) is an exercise and weight management programme which entails physiotherapy support for people suffering from hip or knee osteoarthritis (OA) and a body mass index (BMI) of over 35. The views and experiences of the LMP among patients and professionals have been examined in this study along with insights for future programmes.

The focus groups comprised of 5 referring clinicians and 6 delivering professionals. Three referring GPs and nine patients who attended the LMP participated in the semi‐structured interviews with questions like reasons for taking up and continuing the programme or not, and experiences and outcomes. The qualitative data was assessed using the framework method.

All in all, the patients and professionals valued the multidisciplinary nature of the LMP. But, the professionals described feeling guilty about delaying patients on the orthopaedic waiting list and assumed that the programme should be redirected to those with less severe OA and lower BMI. The referring clinicians differed in their interpretation of the referral criteria and expressed varying levels of autonomy in case of making the referrals. The patients referred following consultation with their general practitioner seemed to be more pleased with the referral process. The patients were persuaded to improve health, their likelihood of surgery and the social benefits. Nevertheless, the patients were discouraged by lack of readiness to change, inconvenience, cost and embarrassment.

The authors of this study concluded that the programme might be better focused on rehabilitation for patients with a lower BMI and less severe symptoms.