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Best Pract Res Clin Rheumatol. 2016 Jun;30(3):503-535. doi: 10.1016/j.berh.2016.09.003.

Osteoarthritis: Models for appropriate care across the disease continuum.

Author information

1
Department of Medicine, Thurston Arthritis Research Center, University of North Carolina, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599-7280, USA; Center for Health Services Research in Primary Care, Department of Veterans Affairs Medical Center, Durham, NC, USA. Electronic address: kdallen@email.unc.edu.
2
Department of Orthopaedics and The University of Melbourne, Level 2, Clinical Sciences Building, 29 Regent Street, Fitzroy, 3065, Victoria, Australia; Department of Surgery, St. Vincent's Hospital Melbourne, Level 2, Clinical Sciences Building, 29 Regent Street, Fitzroy, 3065, Victoria, Australia.
3
Division of Health Care and Outcomes Research, Krembil Research Institute, University Health Network, MP11-322, 399 Bathurst Street, Toronto, ON, M5T2S8, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, MP11-322, 399 Bathurst Street, Toronto, ON, M5T2S8, Canada; Institute of Rehabilitation Science, Canada; Departments of Physical Therapy and Surgery, University of Toronto, MP11-322, 399 Bathurst Street, Toronto, ON, M5T2S8, Canada.
4
Institute of Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Keele University, Keele, ST5 5BG, UK.
5
Sport Injury Prevention Research Centre, University of Calgary, Canada; Faculty of Kinesiology, Cumming School of Medicine, University of Calgary, Canada.
6
Institute of Bone and Joint Research, The Kolling Institute, The University of Sydney, Sydney, Australia; Rheumatology Department, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia.
7
Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham & Women's Hospital & Boston University School of Public Health - US, 75 Francis Street, BC-4-4016, Boston, MA, 02115, USA; Policy and Innovation eValuations in Orthopedic Treatment (PIVOT) Research Center, Department of Orthopedic Surgery, Brigham & Women's Hospital & Boston University School of Public Health - US, 75 Francis Street, BC-4-4016, Boston, MA, 02115, USA.
8
San Diego Musculoskeletal and Joint Research Foundation, Private Practice, American Academy of Orthopaedic Surgeons Health Care Systems Committee, San Diego, CA, USA.
9
Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark.
10
Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital, 9000, Aalborg, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200, Slagelse, Denmark.
11
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation. The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The BOA-registry, Center of Registers Västra Götaland, Centre of Registers Västra Götaland, 41345, Gothenburg, Sweden.
12
Reade Centre for Rehabilitation and Rheumatology, Rehabilitation Research Centre, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands.
13
Department of Physical Therapy, Faculty of Rehabilitation Medicine and Glen Sather Sports Medicine Clinic, University of Alberta, 2-50 Corbett Hall, 8205-114 Street, Edmonton, AL, T6G 2G4, Canada.

Abstract

Osteoarthritis (OA) is a leading cause of pain and disability worldwide. Despite the existence of evidence-based treatments and guidelines, substantial gaps remain in the quality of OA management. There is underutilization of behavioral and rehabilitative strategies to prevent and treat OA as well as a lack of processes to tailor treatment selection according to patient characteristics and preferences. There are emerging efforts in multiple countries to implement models of OA care, particularly focused on improving nonsurgical management. Although these programs vary in content and setting, key lessons learned include the importance of support from all stakeholders, consistent program delivery and tools, a coherent team to run the program, and a defined plan for outcome assessment. Efforts are still needed to develop, deliver, and evaluate models of care across the spectrum of OA, from prevention through end-stage disease, in order to improve care for this highly prevalent global condition.

KEYWORDS:

Health services; Implementation; Osteoarthritis; Quality of healthcare

PMID:
27886944
DOI:
10.1016/j.berh.2016.09.003
[Indexed for MEDLINE]

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