Background Knee osteoarthritis (KOA) is a common chronic disease in Switzerland, associated with high socioeconomic costs and increasing prevalence due to aging and other risk factors. International guidelines recommend a stepped approach focusing on exercise, education, and weight management; however, implementation remains inconsistent. Switzerland has one of the highest knee replacement rates among OECD countries, suggesting potential overuse and indicating an evidence–performance gap in KOA management. Analysis Current efforts promote coordinated, patient-centered care. A repeated stakeholder dialogue in 2024 with representatives of medical and physiotherapy associations, patient organizations, health insurers, and researchers identified challenges: variation in patient pathways across providers; non-evidence-based treatment sequencing with premature escalation to specialist care; and misalignment of expectations between patients and providers. Policy Options Proposed strategies include: (1) establishing a national Model of Care based on a consensus treatment framework; (2) strengthening patient health literacy through targeted education; and (3) facilitating patient navigation through effective communication and shared decision-making. Conclusion Closing the evidence–performance gap requires collaboration among healthcare providers to improve outcomes, reduce inappropriate care, and support coordinated patient-centered KOA management in Switzerland.
Moetteli-Graf et al. (Thu,) studied this question.