A new quality standard on osteoarthritis has been designed to reduce variation in care.
Issued by NICE, quality standard QS87 sets out eight statements covering the diagnosis, assessment, management, ongoing review and referral for joint surgery of adults who have osteoarthritis.
Statement intentions include
reducing the harm from X-ray exposure and limiting unnecessary imaging procedures,
encouraging better self-management, stepping up exercise and weight loss where appropriate
supporting the patient with non-surgical treatments for at least three months before considering joint surgery, and
avoiding the use of scoring tools to see if a patient should be considered for surgical intervention.
“Osteoarthritis is the most common form of arthritis and a leading cause of pain and disability. It has a higher prevalence in women than men and affects around 7.3 million people in England – a figure that is likely to rise due to an ageing population and increasing rates of obesity,” says NICE.
“This quality standard focuses on improving the overall care of adults with osteoarthritis and the management of their condition, to improve symptom control, promote self-management and improve consistency of referral for consideration of joint surgery.”
While QS87 should apply across the whole care pathway, “it will mainly be used in primary care by GPs and allied healthcare professionals.”
The eight quality statements in QS87 are as follows:
Adults aged 45 or over are diagnosed with osteoarthritis clinically without investigations if they have activity-related joint pain and any morning joint stiffness lasts no longer than 30 minutes.
Adults newly diagnosed with osteoarthritis have an assessment that includes pain, impact on daily activities and quality of life.
Adults with osteoarthritis participate in developing a self‑management plan that directs them to any support they may need.
Adults with osteoarthritis are advised to participate in muscle strengthening and aerobic exercise.
Adults with osteoarthritis who are overweight or obese are offered support to lose weight.
Adults with osteoarthritis discuss and agree the timing of their next review with their primary healthcare team.
Adults with osteoarthritis are supported with non-surgical core treatments for at least three months before any referral for consideration of joint surgery.
Healthcare professionals do not use scoring tools to identify which adults with osteoarthritis are eligible for referral for consideration of joint surgery.
Under each of the statements is information about the rationale, quality measures, and what the statements mean for patients as well as service providers, healthcare professionals and commissioners.
Definitions are also included, including suggestions for inclusion in a self-management plan for osteoarthritis, suitable exercise, advice on weight loss and on non-surgical core treatments.
With regards scoring tools, QS87 says: “The use of orthopaedic scores and questionnaire-based assessments to identify people who are eligible for referral for consideration of joint surgery has become widespread. These usually assess pain, functional impairment and sometimes radiographic damage.
“The commonest are the New Zealand score and the Oxford Hip or Knee score. Many (such as the Oxford tools) were designed to measure population‑based changes after surgery, and none have been validated for assessing appropriateness of referral.”
Ource: http://www.thegoodhealthsuite.co.uk/
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