Objective: To understand current practices and identify barriers and facilitators to implementing guideline recommended core OA treatments in China. Methods: An exploratory mixed-methods design was employed, involving healthcare professionals managing OA in mainland China. The qualitative phase included semi-structured interviews (n=15) and a qualitative survey (n=181). A quantitative survey (n=302) evaluated the clinical applicability of identified themes, common practices, knowledge, and self-rated confidence in core capabilities about OA. Qualitative data were analyzed through thematic and content analysis using NVivo, and descriptive statistics were applied to quantitative data using RStudio. Results: Participants representing six professions provided their perspectives qualitatively. Five themes emerged as barriers: widespread misconceptions about OA; limitations in current medical insurance policies; insufficient multidisciplinary collaboration; lack of workplace support; and low patient adherence to self-management. Three themes emerged as facilitators: telehealth and community-based delivery pathways; professional training and patient education resources; and personalized services with positive feedback. Across 19 provinces in China, participants representing seven different health professions completed the quantitative survey. The most commonly used treatments for OA were physical agent therapy (56%), while exercise therapy was utilized by only 9%. The average OA knowledge score was 31.2 (±8.9) out of 55. Self-rated confidence was lowest for "referrals and interdisciplinary collaboration" (3.4±0.1, "somewhat confident"). The most applicable factors impacting the implementation of core OA treatments included patient comorbidities, knowledge of pain science and exercise therapy, and financial support (all 2.8±0.8, "applicable"). Conclusion: Core OA treatments recommended by international clinical guidelines are infrequently implemented in China. Targeted efforts are needed to optimize their delivery, focusing on interdisciplinary collaboration, developing adaptive Chinese OA educational resources for all stakeholders, providing supports for practitioners in the workplace, and improving relevant service accessibility.

The authors have declared no competing interest.

This study was funded by the National Social Science Fund of China [23BTY117].

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The Ethics Committee of the First Affiliated Hospital of Xiamen University gave ethical approval for this work (XMFHIIT-2023SL140).

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