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Osteoarthritis in older or frail people with multiple long-term conditions commissioning brief




The aim of the Health Technology Assessment (HTA) Programme is to ensure that high quality research information on the clinical effectiveness, cost-effectiveness and broader impact of healthcare treatments and tests are produced in the most efficient way for those who plan, provide or receive care from NHS and social care services. The commissioned workstream invites applications in response to calls for research on specific questions which have been identified and prioritised for their importance to the NHS, patients and social care.

This is a brief of broader scope from which the programme is interested in potentially funding more than one proposal.

We are interested in proposals for the evaluation of the clinical and cost-effectiveness of interventions to improve the treatment of older or frail adults with osteoarthritis and comorbidities. Applicants should clearly define and justify their choice of patient group (with particular focus on the age range of participants and justification for choices), study design and outcome measures, and explain how the research will fit into the remit of the HTA programme. Applicants should justify why and how revision of an existing intervention would represent a substantial improvement or optimise care for this particular population. Epidemiology or exploratory studies are not eligible for the HTA programme but primary research including randomised and observational studies and evidence syntheses will be considered.

Examples of topics and outcomes of interest include, but are not limited to:

  • Non-pharmacological interventions such as exercise and/or weight loss programmes, with a focus on acceptability, sustainability, and setting.
  • The effectiveness of pharmacological options such as NSAIDs and opioids.

Background information for potential applicants

Osteoarthritis (OA) is the most common form of arthritis in the UK, affecting nearly nine million people, and this number is expected to increase as people live longer. It often develops in people in their mid-forties, and whilst the exact cause of OA is not known, risk factors for developing OA include ageing and obesity. It is a lifelong condition, causing joint pain, swelling, and problems with mobility, which can affect patients’ ability to participate in activities of daily living. Exercise and weight loss are recommended for all patients with OA, followed by pharmacological treatments such as paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioids if symptoms are still present. All pharmacological treatments have potential side effects.

With an increasingly ageing population, more people are living into older age with OA as well as comorbidities such as cardiovascular disease and diabetes. ‘Multiple long-term conditions’ refers to patients who have two or more chronic conditions and it is not known how best to treat older patients with OA and comorbidities. Patients with comorbidities are high users of healthcare resources and therefore it is important to know what the most effective treatments are.

The HTA programme therefore wishes to commission research into the clinical and cost-effectiveness of interventions to improve the treatment of older or frail adults with osteoarthritis and comorbidities, taking into account ongoing initiatives in this field. Such interventions should be defined and justified by
applicants and are not limited to those specified as examples above.

Additional commissioning brief background information

A background document is available that provides further information to support applicants for this call. It is intended to summarise what prompted the call and the existing evidence base, including relevant work from the HTA and wider NIHR research portfolio. It was researched and written on the basis of information from a search of relevant sources and databases, and in consultation with a number of experts in the field. If you would like a copy please email

Making an application

Please note that this call will open late-April. The advert on the funding opportunities page will be updated with the call opening date once confirmed and the link to the application form will be available once the call opens. Potential applicants are advised to check that advert for updates on the call open date.

Your application must be submitted on-line no later than 1pm on the 1 September 2021. Applications will be considered by the HTA Funding Committee at its meeting in November 2021.

Guidance notes and supporting information for HTA Programme applications are available by clicking the links.

Important: Shortlisted Stage 1 applicants will be given eight weeks to submit a Stage 2 application. The Stage 2 application will be considered at the Funding Committee in March 2022.

Applications received electronically after 1300 hours on the due date will not be considered.

For commissioned topics, the Programme strongly discourages the practice of the same co-applicant joining more than one competing team. There may be unusual circumstances where the same person could be included on more than on application eg a lead from a named charity or a unique national expert in a condition.

For such exceptions (i) each application needs to state the case as to why the same person is included (ii) the shared co-applicant should not divulge application details between teams and (iii) both teams should acknowledge in their application that they are aware that one of their co-applicants is part of a competing application and that study details have not been shared.

Should you have any queries please contact us: