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Authors note better adherence to evidence-based OA guidelines needed

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Clinicians who care for patients with osteoarthritis likely do not follow practice guidelines based on current medical evidence, according to results appearing in Arthritis Care & Research.

David J. Hunter, MD, PhD, and colleagues noted that although weight loss and exercise are indicated in these cases, most physicians prescribed medications for pain and inflammation to manage the chief symptoms of osteoarthritis (OA). Some even opted for surgical interventions rather than recommending the more conservative approach to treating OA.

The authors stressed that such aggressive therapeutic interventions do not facilitate improvement in joint structure or long-term disease relief, according to an American College of Rheumatology press release.

“We present a potential roadmap for optimizing the quality of OA health care for those developing and enforcing policy decisions, and for clinicians on the frontlines of OA management to enact practice change,” Hunter stated in the release.

According to the release, physicians do not recommend conservative non-pharmacologic management therapies frequently, and this can lead to unnecessary diagnostic imaging and inappropriate referral to orthopedic surgeons. Therefore, Hunter and colleagues support medical evidence which recommends that more conservative approaches be used.

“Weight management and exercise programs tend to be overlooked by clinicians,” Hunter stated in the release. “These conservative approaches are beneficial to patients who adhere to weight-loss and exercise programs.”

Other findings from the study cited the use of inappropriate procedures, like routine knee arthroscopy, and overusing diagnostic imaging in place of a clinical diagnosis in managing OA.

Reference:

• Hunter DJ. Arthritis Care and Research. 2011. doi: 10.1002/acr.20278.

Disclosures: Hunter has no relevant financial disclosures. The study was funded by the Australian Research Council Future Fellowship.

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