Developing a minimum standard of care for treating people with osteoarthritis of the hip and knee

被引:42
作者
March, Lyn [1 ]
Amatya, Bhasker [2 ]
Osborne, Richard H. [3 ]
Brand, Caroline [2 ,4 ,5 ]
机构
[1] Univ Sydney, Royal N Shore Hosp, Dept Rheumatol, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia
[2] Univ Melbourne, Royal Melbourne Hosp, CEHSEU, Parkville, Vic 3052, Australia
[3] Deakin Univ, Melbourne, Vic 3125, Australia
[4] Monash Univ, CREPS, Clayton, Vic 3800, Australia
[5] Univ Melbourne Hon, Dept Med, Parkville, Vic 3052, Australia
来源
BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY | 2010年 / 24卷 / 01期
关键词
osteoarthritis knee; osteoarthritis hip; clinical practice guidelines; model of care; evidence-based practice; clinical indicators; DECISION-SUPPORT-SYSTEMS; IMPROVING PRIMARY-CARE; QUALITY INDICATORS; STANDING-COMMITTEE; SELF-MANAGEMENT; TASK-FORCE; EULAR RECOMMENDATIONS; DISEASE MANAGEMENT; CHRONIC ILLNESS; ARTHRITIS;
D O I
10.1016/j.berh.2009.10.002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We reviewed three recently published guidelines for the management of osteoarthritis (OA) and considered the evidence and potential for implementation. From this we propose a minimum standard of care, or a 'core set' of interventions that should be, offered to all patients with OA of the hip and/or knee. Eight core recommendations emerged where it is recommended that health-care professionals: Provide advice about, and offer access to appropriate information for OA self-management and lifestyle change Provide advice about weight loss if patient is overweight or obese and refer to services as required Provide advice for land-based exercises incorporating aerobic and strengthening components and refer to services as required Recommend adequate paracetamol for pain relief Make patients aware that non-steroid anti-inflammatory drugs (NSAIDs) or coxibs can improve symptoms in majority but this comes with potential for harm and that risk potential varies - be aware of and minimise the individual's risk potential Offer intra-articular steroids for short-term relief of a flare or acute deterioration in symptoms. Offer stronger analgesic relief if prolonged severe symptoms Offer access to assessment for arthroplasty for consumers with severe symptomatic CIA not responding to conservative therapy An integrated, chronic disease model of care is proposed to best implement OA management and a check list of clinical indicators/performance measures is provided. (C) 2009 Published by Elsevier Ltd.
引用
收藏
页码:121 / 145
页数:25
相关论文
共 61 条
[1]  
*ACHS, 2009, ACHS CLIN IND PROGR
[2]   Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management [J].
Adams, Sandra G. ;
Smith, Paulla K. ;
Allan, Patrick F. ;
Anzueto, Antonio ;
Pugh, Jacqueline A. ;
Cornell, John E. .
ARCHIVES OF INTERNAL MEDICINE, 2007, 167 (06) :551-561
[3]  
Altman RD, 2000, ARTHRITIS RHEUM-US, V43, P1905
[4]  
American Academy of Orthopaedic surgeons, 2003, AAOS CLIN GUID OST K
[5]  
[Anonymous], 2006, National Chronic Disease Strategy
[6]  
[Anonymous], 2001, Crossing the Quality Chasm: A New Health Care System for the 21st Century
[7]   Using assessing care of vulnerable elders quality indicators to measure quality of hospital care for vulnerable elders [J].
Arora, Vineet M. ;
Johnson, Martha ;
Olson, Jared ;
Podrazik, Paula M. ;
Levine, Stacie ;
DuBeau, Catherine E. ;
Sachs, Greg A. ;
Meltzer, Anddavid O. .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2007, 55 (11) :1705-1711
[8]  
*AUSTR GOV DEP HLT, 1999, ENH PRIM CAR PROGR E
[9]  
*AUSTR I HLTH WELF, 2009, 75 HSE AUSTR I HLTH
[10]   Improving primary care for patients with chronic illness [J].
Bodenheimer, T ;
Wagner, EH ;
Grumbach, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (14) :1775-1779