Temi

International clinical guidelines for the conservative management of knee osteoarthritis (OA) recommend exercise, education, and weight control as first-line treatment for all people with knee OA. However, findings from various health care settings have identified an underuse of exercise and education. A recent survey among medical specialists in Switzerland identified an evidence-performance gap, implying that the strong evidence in favour of exercise is not being transferred into clinical practice. This policy brief describes the challenges facing the improvement of conservative disease management by presenting recommendations regarding i) tanslation of guideline recommendations into a specific exercise and education programme ii) facilitation of the systematic application of exercise through standardised treatment pathways and iii) promotion of the benefits of exercise in the long-term management of chronic diseases.

The Swiss Health System is a complex system with different groups of actors for which data is collected and analyzed using various methods, leading to a large heterogeneity and dispersion of available data. The specificities of a Swiss Health System favor a hybrid infrastructure to manage the heterogeneity and dispersion of Swiss health-related data. This policy brief shows the importance of a metadata management infrastructure to identify and describe health data resources and highlights several essential key elements for the design of a metadata repository and also raises important practical questions.