Navigation Links
Clinical practitioners not adhering to evidence-based guidelines for osteoarthritis
Date:1/4/2011

New research found clinicians who care for patients with osteoarthritis (OA) are likely not following standard care guidelines that are based on current medical evidence. Researchers noted physicians were prescribing medications for pain and inflammation, or opting for surgical interventions rather than recommending weight loss plans or exercise programs to OA patients. Details of the this study are available in the January 2011 issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.

A 2002 report by the World Health Organization (WHO) estimated OA to be the fourth leading cause of years lost due to disease (YLD) worldwide. OA disability is quickly becoming a major public health concern with experts suggesting that by 2020 the number of people with OA will have doubled due to growing obesity prevalence and the aging of the "baby boomer" generation. According to the Centers for Disease Control and Prevention (CDC), arthritis and other rheumatic conditions cost the U.S. $128 billion in 2003a 24% increase since 1997. Much of the cost burden in arthritis care can be attributed to OA which accounts for a large volume of surgical procedures including total joint replacements.

Dr. David Hunter from the University of Sydney in Australia and New England Baptist Hospital in Boston, Massachusetts and colleagues reviewed how standard clinical practice diverges from evidence-based recommendations in the management of OA. "We present a potential roadmap for optimizing the quality of OA healthcare for those developing and enforcing policy decisions, and for clinicians on the frontlines of OA management to enact practice change," commented Dr. Hunter.

Current clinical practice does not reflect recommendations based upon medical evidence. The authors report that therapeutic interventions are primarily aimed at reducing pain and improving joint function by using therapies that target symptoms, but do not facilitate improvement in joint structure or long-term betterment of the disease. Frequently, physicians do not recommend conservative non-pharmacologic management therapies which leads to unnecessary diagnostic imaging and inappropriate referrals to orthopedic surgeons.

Many individuals with OA are overweight or obese. The authors support medical evidence which recommend a conservative non-pharmacologic management for OA patients. "Weight management and exercise programs tend to be overlooked by clinicians," said Dr. Hunter. "These conservative approaches are beneficial to patients who adhere to weight-loss and exercise programs."

Researchers further suggest that surgery be resisted when symptoms can be well managed by other treatment methods. The typical indications for a surgical approach in treating OA are debilitating pain and major limitation of functions such as walking, working, or sleeping. However, prior studies have shown that up to 30% of some surgical procedures are inappropriate and recent recommendations suggest routine arthroscopy for knee OA management should be avoidedsomething not reflected in clinical practice.

The study team also noted an overuse of inappropriate diagnostic imaging instead of clinical diagnosis based on history and physical examination. Based on current guidelines imaging should be reserved for instances where a diagnosis is unclear and radiography could rule out other diseases that may produce similar symptoms. Research studies estimate there are 95 million high-tech scans (CT, MRI, PET) done annually in the U.Srepresenting a $100 billion industry, of which $14 billion has been shouldered by Medicareand 20% to 50% of these scans were unnecessary as the results failed to help treat or diagnose the patient's symptoms.

"Eliminating unproven procedures and reducing needless costs is necessary to improve the quality and lower the cost of healthcare in the U.S.," concluded Dr. Hunter. "The management of OA should focus on a patient-centered and provider integrated approach that improves quality and reduces cost by following evidence-based recommendations."


'/>"/>

Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Clinical decision support systems help control inappropriate medical imaging, study suggests
2. Peptide delivers 1-2 punch to breast cancer in pre-clinical study
3. Collaboration offers NIH Clinical Center resources to Damon Runyon clinical investigators
4. Use the right metaphor to get patients to enroll in clinical trials
5. Clinical trial for Rett syndrome launched
6. Drugs are safe, active in patients normally ineligible for clinical trial
7. Swiss agency approves clinical trial of UCI-created neural stem cell therapy
8. Onconova to present clinical trials update on ON 01910.Na at American Society of Hematology Meeting
9. International clinical trial tests targeted drug for melanoma
10. Prostate cancer clinical stage does not predict recurrence
11. Growth factor regenerates tooth supporting structures: Results of a large randomized clinical trial
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating in cancer ... they remain in the eye of the beholder, according to experts who offered insights ... American Journal of Managed Care. For the full issue, click here . , ...
(Date:6/26/2016)... Lake Orion, Clarkston, Michigan (PRWEB) , ... June ... ... direction with respect to fertility once they have been diagnosed with endometriosis. These ... tolerable intercourse but they also require a comprehensive approach that can help for ...
(Date:6/25/2016)... Lewisville, TX (PRWEB) , ... June 25, 2016 , ... ... in the United States, named Dr. Sesan Ogunleye, as the Medical Director of its ... be the facility Medical Director of our new Mesquite location,” said Dr. James M. ...
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published June ... with. The article goes on to state that individuals are now more comfortable seeking ... common operations such as calf and cheek reduction. The Los Angeles area medical group, ...
(Date:6/24/2016)... ... ... Global law firm Greenberg Traurig, P.A. announced that 20 Florida attorneys are recognized ... this recognition are considered among the top 2 percent of lawyers practicing within the ... this year’s Legal Elite Hall of Fame: Miami Shareholders Mark D. Bloom, Burt ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 2016  Collagen Matrix, Inc., ("Collagen Matrix") the ... of collagen and mineral based medical devices for ... Bill Messer has joined the company as ... the growing portfolio of oral surgery, neurosurgery, orthopaedic ... joins the Collagen Matrix executive team as an ...
(Date:6/24/2016)... CAMBRIDGE, Mass. , June 24, 2016 /PRNewswire/ ... the Spaulding Rehabilitation Network,s Dean Center for ... of Physical Medicine and Rehabilitation, MIT Hacking Medicine, ... Center for Innovation, today announced the five finalists ... Hackathon for Lyme disease.  More than 100 scientists, ...
(Date:6/24/2016)... 24, 2016 Research and ... "Structural Electronics 2015-2025: Applications, Technologies, Forecasts" report ... In-Mold Electronics, Smart Skin, Structural Health Monitoring, ... Structural electronics involves electronic and/or electrical components ... replacing dumb structures such as vehicle bodies or ...
Breaking Medicine Technology: