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We aimed to estimate the proportion of variance in patient outcomes from a structured rehabilitation programme explained by therapist effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For our observational cohort study, we accessed data from the national multicentre Good Life with osteoArthritis in Denmark (GLA:D) osteoarthritis management programme. Analyses included 23\u2009021 consecutive eligible adults with hip or knee osteoarthritis (mean (SD) age 65.0 (9.8) years, 71% female) treated by 657 therapists between October 2014 and February 2019. The primary outcome was \u226530% reduction in pain intensity on 0\u2013100 visual analogue scale (VAS) at 3 months. Therapist effects were estimated as the variance partition coefficient (intraclass correlation coefficient (ICC)) from two-level random intercept logistic regression models before and after adjusting for patient-level case-mix factors and therapist-level characteristics (number of patients treated, days since therapist certification). Analyses were repeated for a range of secondary outcomes using multiply imputed data and complete-case analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>52% of patients reported a \u226530% reduction in pain intensity on 0\u2013100 VAS at 3 months. In the null model, the ICC was 0.007 (95% CI 0.005 to 0.009), which changed little after adjusting for patient-level and therapist-level covariates. Upper confidence limits for ICC estimates across all secondary outcomes in multiply imputed data and complete-case analyses were &lt;0.03.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a nationally implemented osteoarthritis management programme delivered by trained healthcare professionals, therapist effects made a minimal contribution to variation in patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2026-007100","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:10:20Z","timestamp":1782317420000},"page":"e007100","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Therapist effects in real-world rehabilitation outcomes: a cohort study of the nationwide GLA:D osteoarthritis management programme in Denmark"],"prefix":"10.1136","volume":"12","author":[{"given":"Philips Edomwonyi","family":"Obasohan","sequence":"first","affiliation":[{"name":"Department of Liberal Studies, College of Administrative and Business Studies, Niger State Polytechnic, Bida, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Palmer","sequence":"additional","affiliation":[{"name":"Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK"},{"name":"School of Health & Social Care, Sheffield Hallam University, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Alderson","sequence":"additional","affiliation":[{"name":"Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK"},{"name":"School of Health & Social Care, Sheffield Hallam University, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8449-7725","authenticated-orcid":false,"given":"Dahai","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Medicine, Keele University, Keele, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-1175","authenticated-orcid":false,"given":"Dorte T","family":"Gr\u00f8nne","sequence":"additional","affiliation":[{"name":"Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark"},{"name":"The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Central and West Zealand Hospital, Slagelse, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa M","family":"Roos","sequence":"additional","affiliation":[{"name":"Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4336-7059","authenticated-orcid":false,"given":"S\u00f8ren T","family":"Skou","sequence":"additional","affiliation":[{"name":"Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark"},{"name":"The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Central and West Zealand Hospital, Slagelse, Denmark"},{"name":"Department of Research, Central and West Zealand Hospital, Slagelse, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9008-0184","authenticated-orcid":false,"given":"George M","family":"Peat","sequence":"additional","affiliation":[{"name":"Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"2026062409101088000_12.2.e007100.1","unstructured":"Thomas J , Petticrew M , Noyes J , et al . 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