Management of Osteoarthritis
Osteoarthritis (OA) is a chronic disease which most commonly affects the knee, hips and hands. OA is one of the leading causes of disability worldwide with estimates of over 2 million Australians living with the condition. People with OA report living with chronic pain, physical disability, functional impairment, as well as sleep, psychosocial and work difficulties.
There is national and international consensus for the conservative care of hip and knee OA as a first line strategy before consideration for elective joint replacement surgery. Conservative care includes exercise, weight loss, pharmacologic treatment, pain management and self-management support as safe and effective treatments for osteoarthritis. Despite this, pilots of the Osteoarthritis Chronic Care Program (OACCP) consistently found that almost 70 per cent of people being placed on the NSW elective joint replacement waitlist had not accessed conservative care, besides pain medications.
The model of care for the Osteoarthritis Chronic Care Program (OACCP) describes a comprehensive, coordinated, multidisciplinary conservative care program for osteoarthritis of the hip and/or knee. It is underpinned by a chronic care approach that is person-centred, collaborative and evidence-based. The OACCP targets activities that will support improvements in pain, function and quality of life for the individual living with osteoarthritis. But importantly it addresses individual, social, psychological and comorbidity management in order to be truly person-focussed.
A formative evaluation of the OACCP model of care (2015) showed 1) improved pain and comorbidity management, 2) better function, mobility and quality of life, 3) improved readiness for surgery and; 4) more appropriate surgical waitlists.