Osteoarthritis Initiative Calls For New Approach

Outcomes for patients with osteoarthritis (OA) could be improved with changes in the current approach to the disease, such as paying attention to their symptoms; following up both proactively and longitudinally; and applying the principles of integrated, multispecialty systems of care, according to the US Bone and Joint Initiative (USBJI). To help improve the current approach to managing OA, the USBJI convened the Chronic Osteoarthritis Management Initiative (COAMI) Work Group earlier this year. As a result of the meeting, a Call to Action has been issued.

Work Group members include orthopedic nurses and surgeons, specialists in rheumatology and rehabilitation and sports medicine, osteopathic physicians, physical therapists, and athletic trainers. They identified the following priority actions to undertake with the help of partners in other organizations who share COAMI’s goals for improved patient outcomes:

• Develop a Call to Action geared specifically to health care professionals who treat patients with OA, as well as policy makers and the public.

• Convene a larger conference that leads to further recommendations that would build agreement across disciplines and specialties within the health care system so that current inconsistencies in approach might be resolved and models of care developed.

• Reach out to other partners beyond Work Group members to include them in future COAMI work.

• Explore standardized screening tools and indicators of OA to make early diagnosis both more consistent and more likely.

• Develop tools and prompts that promote patient engagement in learning about and managing OA, especially before symptoms become debilitating.

• Lend COAMI's support to existing advocacy and awareness efforts.

• Develop and support an OA-specific research agenda that would fill gaps in evidence and practice.

OA could be viewed as a chronic condition, the USBJI noted, but it is not usually approached that way. For example, the standard for other chronic conditions (eg, diabetes mellitus and heart disease) now involves screening for risk factors, prevention-oriented interventions, ongoing monitoring, and comprehensive care models. OA interventions tend to start later in the disease process. Many patients and health care professionals tolerate and expect joint pain as an anticipated consequence of aging and joint replacement as an inevitable end point of OA. For more information about the initiative, visit the USBJI Web site at http://www.usbjd.org.