Earlier diagnosis and changes to funding are urgently needed to allow the ‘tsunami’ of elderly patients with osteoarthritis to access the vital subsidised allied health services they need, a leading rheumatologist says.
Professor Lyn March, Liggins Professor of Sydney University’s Rheumatology and Musculosketal Epidemiology Medicine, Northern Clinical School, told the limbic that these changes were particularly pressing, especially as Australia faces a growing health burden from its ageing population.
“Appropriate investment earlier in the life course will reap significant savings on surgical and institution costs in the longer term,” she said.
“We need to act now as the tsunami of older people in pain is with us now.”
Professor March was commenting on an article she co-authored in the Australian and New Zealand Journal of Public Health, which looked at the impact of incident osteoarthritis (OA) on health services use by Australian women born between 1946 and 1951.
“This study provides a rare insight into change in healthcare use for people reporting incident OA, against an appropriate comparison group, highlighting the importance of early diagnosis of OA to optimise effective use of health services,” the authors wrote.
“A pre-existing higher use of health services is associated with reporting incident OA, compared to those who never report arthritis. After onset of OA, rate of doctor use reduced and allied health use increased, consistent with recommended Australian treatment guidelines.”
She stressed the importance of diagnosing OA early through taking a detailed history and completing a physical examination of the symptomatic joint(s).
“Exercises and weight loss are proven interventions that can improve pain and function in osteoarthritis and the earlier these are commenced the better the outcome,” she said.
“Given that lifestyle change can be difficult for so many of us, access to a range of appropriately trained allied health professionals can greatly facilitate this.”
Professor March said it was a “great start that the policy makers recognise that chronic diseases like osteoarthritis need more time and access to a team to manage them well.”
“Access to five allied health services is important and was a good start but it clearly is not enough,” she said.
Osteoarthritis and musculoskeletal pain are key barriers to physical activity in the elderly, and loss of mobility and loss of mind are the key factors related to loss of independence in the elderly.
“Regular physical activity may even ward off dementia,” Professor March said. “So we all need good musculoskeletal health and need to pay attention to the bones and joints as the population is ageing.”