Joint implementation of guidelines for osteoarthritis in western Europe

JIGSAW-E supports primary care in six European countries to address the unmet needs of adults with osteoarthritis (OA) through the systematic implementation of international guidelines for the best care and management of osteoarthritis. The JIGSAW-E toolkit offers supported self-management for those consulting in primary care.


In the EU, OA is usually managed in primary care, and delivery of quality OA care is highly variable. Self-management of long-term illnesses and support for self-management are emphasised in clinical guidelines across Europe, but patients say they need help from primary care to achieve self-management. Using research by Keele University and methods piloted in the UK, JIGSAW-E implements a model of supported self-management for OA – joint pain that typically effects those 45 and older and limits everyday activities.


JIGSAW-E works through an international community of practice, bringing together academics, primary-care health professionals, industry partners and citizens in shaping local solutions to implementation challenges. The team is founded on academic leadership, dedicated project management, a committed network of clinical champions, and patient champions with lived experience of OA.

The project

JIGSAW-E supports the systematic implementation of international guidelines and quality standards for OA across six European collaborating sites in six countries. The goal is to ensure consistent care for OA, the most common chronic joint condition, and to help patients understand and self-manage their ailment.

JIGSAW-E addresses the challenge of managing OA with a focus on quality non-pharmacological therapy: written patient information; exercise; physical activity; and advice on diet and weight-management. JIGSAW-E has introduced a new model of supported self-management in primary care pilot sites and evaluated its impact using audits of OA Quality Indicators – collected using an OA e-template – and routinely recorded general practice medical records.

The JIGSAW-E innovation package includes:

  • OA guidebook written by patients and health professionals
  • Model OA consultation for primary care
  • Training for professionals
  • Medical record and patient derived Quality Indicators of OA care

EIT Health’s unique structure has helped stimulate cross-fertilisation of ideas between SMEs, academia, citizens and clinical practice to support scale-out of this project


JIGSAW-E will impact OA patients and the carers who serve them with these beneficial results:

  • Strong citizen involvement and engagement
  • Bespoke patient information
  • A champion network of patients who co-create solutions
  • International collaboration across sites of best practice
  • An international community of practice whose members help shape solutions
  • An innovation package for scale-up
  • Knowledge mobilisation that facilitates systematic service-level change

Why this is an EIT Health project

This project’s mission of empowering patients is at the heart of what EIT Health is seeking to do. It is also in keeping with the EIT Health Focus Areas of:

  • “Bringing Care Home”, because it enables patients to manage their own care with support from health care professionals.
  • “Healthcare Transformation”, because it improves management of chronic conditions, a challenging healthcare problem.

External Partners:

  • University of Southern Denmark
  • University of the Algarve
  • Diakonhjemmet Hospital, Norway
  • Edinburgh Napier University
Mrs Nicola Evans
| Implementation Project Manager | Keele University
Mrs Helen Duffy
| NHS Partnerships & Engagement Manager | Keele University