The COAMI report proposes a shift in the treatment paradigm from the current episodic and reactive approach to one that is similar to treatment for diabetes and other chronic diseases.
The group focused their efforts on the following seven priorities:
- Issue a call to action for healthcare professionals, policy makers, and the public;
- Hold a conference to build agreement across disciplines;
- Communicate with other partners beyond their group;
- Explore standard screening tools;
- Promote patient engagement;
- Support existing advocacy; and
- Develop and support an osteoarthritis-specific research agenda.
Changing the Paradigm Begins with Awareness
Existing advocacy for OA needs an update, agrees Roland Chang, MD, professor of preventive medicine, senior associate dean for public health, and director of the Institute for Public Health and Medicine at Northwestern University Feinberg School of Medicine in Chicago. He uses the analogy of preventive cardiology during its early years.
“I would say that rheumatology is where cardiology was in the 1950s,” says Dr. Chang. “Everybody thought at that time that heart attacks were an inevitable consequence of aging and we really couldn’t prevent them.”
Dr. Chang notes that following years of cardiology research, efforts switched from averting a second heart attack to avoiding even the first one through prevention measures, lifestyle changes, and better monitoring of people with high risks for heart disease.
With OA, a lack of public knowledge about disease symptoms and treatment options often mirrors that of primary healthcare providers.
The common public perspective used to be that “OA was something your grandmother got,” notes Dr. Iversen. “Now we know that osteoarthritis can be caused by injury, poor biomechanics, and has an inflammatory component. OA may be evident even in young adults who have had a ligament injury.”
A major concern is that OA is not consistently detected and treated. A large portion of the population is either afflicted with the disease or at risk for it. However, most people go to a primary care physician, which means they probably are seldom questioned about joint pain. Furthermore, they may not mention pain on their own, thinking it’s just old-age achiness.
A typical patient who suffers from osteoarthritis might feel pain and stiffness in the joints after prolonged sitting, which may subside with walking or movement. Doctors diagnose the disease through a combination of clinical findings that typically include patient history and symptoms. X-rays are also used, but may not capture early-stage disease, while MRIs provide more conclusive results but are costly.
