Osteoarthritis: GPs Helping Patients Help Themselves
Osteoarthritis is one of the top five conditions managed in general practice, and an increasing number of general practitioners are pursuing the skills required to treat it, according to a recent article in the Medical Journal of Australia.
The article, by Professor Deborah Saltman, Department of General Practice, University of Sydney, Natalie O'Dea, EdAct Pty Ltd, and Professor Philip Sambrook, Royal North Shore Hospital, Sydney, follows the launch of The Bone and Joint Decade, endorsed by the World Health Organization and the United Nations, bringing together health professionals, patients, and industry to raise awareness of the burden of musculoskeletal disorders.
One in five women and one in ten men aged 45 to 64 say they suffer from osteoarthritis. Patients with osteoarthritis of the knee or hip often have multiple comorbidities, such as obesity and hypertension. Without ongoing, GP-supervised treatment, osteoarthritis can be chronically disabling.
"On average, patients see their general practitioners three times a year. It is this contact that places a general practitioner in the ideal position to provide continuing care for patients with osteoarthritis," Dr Saltman says.
A relationship between obesity (usually defined as a BMI >30) and knee osteoarthritis has been confirmed in many studies.Other risk factors of developing osteoarthritis include age; sex; genetics; injury and joint trauma.
"A broad range of physical activities has been shown to reduce pain, stiffness and disability and improve general mobility, muscle strength and quality of life in patients.
"The ability of patients to develop their own management strategies (which may involve other health professionals) needs to be assessed," Dr Saltman says.
GPs are supportive of patients developing skills to manage their own osteoarthritis with follow up consultation with their GP.
Applying a variety of non-pharmacological and pharmacological interventions can assist to prevent the progression of osteoarthritis.
Dr Saltman says there is good evidence that many interventions work, but little good evidence to establish what works best.
"Evidence-based non-pharmacological interventions that work include weight reduction, patient education, monthly telephone calls to follow up, aerobic and strengthening exercises," Dr Saltman says.
Managing Arthritis is published as a Supplement to this issue of the Journal, with the support of Pharmacia Australia and Pfizer. This educational supplement focuses on the pivotal role of the general practitioner in managing chronic musculoskeletal disease, and on osteoarthritis because of its prevalence and importance in the ageing population.