Osteoarthritis in Primary Care

Paper Summary:

This paper proposes a study to review the efficacy of a disease management program for osteoarthritis (OA) in a primary care setting, based on preservation of joint function as well as adequate pain management. For the purposes of this study, the following question is asked: "How does a primary care based medical and educational management program effect the disease progression in patients with mild to moderate osteoarthritis as evidenced by a reduction in pain and progression of disease?" The author hypothesizes that it is insufficient to provide self-administered education programs for OA patients and that an interactive program containing education, pain management, hands on evaluation and frequent follow up will demonstrate patient reports of reduction in daily pain as well as objective demonstration of preservation of function, as evidenced by serial physical examination.

Outline:
Introduction
Statement of the Problem
Literature Review
Research Design

From the Paper:

"Conversely, a study published in the Journal of Rheumatology reports there was no significant improvement in patient function or pain related to implementation of the Arthritis Self Management Program (ASMP). Subjects were recruited for intervention and evaluated at baseline as well as four months after completion of the course or reading of the ASMP manual (This group functioned as the control for the study). No significant clinical benefits were noted at four months in patients who had been recruited from primary care practices, although the authors were able to note an improvement in other patient groups, such as those who had been referred for specialty care. "

Sample of Sources Used:

• Bridges-Webb C, Britt H, Miles DA, Neary S, Charles J, Traynor V. Morbidity and treatment in general practice in Australia. Aust Fam Physician 1993; 22:336-9,342-6.
• S.E. Lamb, F. Toye, and K.L. Barker Chronic disease management programme in people with severe knee osteoarthritis: efficacy and moderators of response Clinical Rehabilitation, February 2008; 22: 169 - 178.
• Lorig KR, Mazonson PD, Holman HR. Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis Rheum. 1993 Apr; 36(4):439-46.
• Solomon DH, Warsi A, Brown-Stevenson T, Farrell M, Gauthier S, Mikels D, Lee TH. Does self-management education benefit all populations with arthritis? A randomized controlled trial in a primary care physician network. J Rheumatol. 2002 Feb; 29(2):362-8
• Steultjens MPM, Dekker J, van Baar ME, Osstendorp RAB, Bijlsma JW. Range of joint motion and disability in patients with osteoarthritis of the knee or hip Rheumatology 2000; 39: 955-961

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