Management of Osteoarthritis in the General practice and Rheumatology outpatients
Shama Khan, Leke Oyedotun, Fayyaz Janjoa, Claire Moore, Donncha O’Gradaigh
Rheumatology Department, University Hospital Waterford
Osteoarthritis poses a considerable burden on both primary and secondary care .While both community and hospital based services strive to cope with the demand, integrated approaches using a multi-disciplinary framework and guidelines for management and referral are frequently lacking.
To evaluate how much conservative measures and services available in the community are utilised in the general practice, before referral to a Rheumatology clinic. We also looked up the number of joints injections, in the Rheumatology Clinic and orthopaedic referral for interventions.
A retrospective study.575 patients were included in the audit. Their 1st and subsequent letters were reviewed. Parametrers included were NSAIDs use, physiotherapy referral by GPs, joint injections, NSAIDs and physiotherapy referral from Rheumatology clinic and orthopaedic referral.
General practice, NSAIDs: 58.71 %, physiotherapy referral: 21.04%. Rheumatology Clinic, Intra articular injections: 41.39%, NSAIDs: 68.17, physiotherapy: 45.91%, Orthopaedic referrals: 22.95%.
Integrerated referral and care pathways are required for efficient and optimal care of patients with osteoarthritis. This will require significant support, education and training for general practice. The concept of GP with special interest would have a quite positive impact.