UCLA Rheumatologist Commends Study
Roy D. Altman, MD, professor of medicine at UCLA, who is not affiliated with this study, calls it a “well written summary of quality indicators of care in osteoarthritis of the knee, although the title suggests it applies to all forms of osteoarthritis.”
Dr. Altman feels that the authors do a good job of pointing out the use of unproven remedies, inadequate use of nonpharmacologic methods, excessive use of imaging, the cost of surgery, and the excessive use of arthroscopy. However, he notes a problem that the article does not address: “None of our therapies, short of joint replacement, is very effective in reducing pain and improving function. In addition, none is uniformly accepted that they can alter the course of osteoarthritis. If there was a therapeutic program that was really effective, the literature would be more definitive, resulting in guidelines that would be more specific and helpful. Adherence would then be less of a problem.”
Hunter et al point out the need for a financial incentive to improve quality indicators of care. “Indeed,” agrees Dr. Altman, “at the present time there is a financial disincentive, as there is a financial penalty for spending time educating the patient.”
Dr. Hunter sees opportunity in the current state of OA care. “The increasing prevalence of osteoarthritis and the focus on health reform provide an opportunity for us to focus attention on redressing health service delivery for this chronic disease,” he says. “If we don’t, the patients themselves and the health care system will only suffer further.”
Sue Pondrom is a medical journalist based in San Diego.
Reference
- Hunter DJ, Neogi T, Hochberg MC. Quality of osteoarthritis management and the need for reform in the US. Arthritis Care Res. 2011;63:31-38.
