New service for patients with musculoskeletal conditions
Comprehensive care at Canterbury Hospital for osteoarthritis and osteoporosis patients
One-stop-shop services that will deliver comprehensive care for patients who have musculoskeletal conditions are being set up at Canterbury Hospital.
“Our team will provide multi-disciplinary care for patients in the one place, at the one time,” Staff Specialist Rheumatologist Dr Mona Marabani said.
“It’s providing care to the community in a new way at the hospital,” she said.
The Osteoarthritis Chronic Care Program (OACCP) and the Osteoporosis Re-Fracture Prevention service (ORP) aim to improve the management of patients who have osteoarthritis and osteoporosis.
The OACCP will provide care for patients who have osteoarthritis in their hips or knees and who are on the hospital’s elective surgery waiting list for a joint replacement.
Arthritis is a chronic disease of the joints and osteoarthritis is its most common form. Arthritis Australia says four million Australians currently live with arthritis. It is the leading cause of chronic pain across the nation. There is no cure for the condition.
In NSW, research shows that almost 70 per cent of about 6000 patients with osteoarthritis, and who are on waiting lists for elective hip or knee joint replacement hadn’t been referred to, or accessed other types of care for their condition, except pain management, before being placed on a waiting list for surgery.
Physiotherapist Andrew Wood will coordinate the new OACCP at Canterbury and lead a team of allied health professionals including a rheumatologist, physiotherapist, dietician and clinical psychologist.
“We will provide an initial assessment for each patient, organise who sees them and devise a holistic management plan for them. We are actively trying to engage patients to better manage their own health during the time they’re waiting for surgery,” he said
A patient’s plan may include ways to better manage pain and medication, exercise and weight loss goals, healthy eating strategies and ways to address stress and anxiety to improve their quality of life.
The team hopes to better prepare those patients who still require surgery, which will aid in their recovery. And, in some cases, negate the need for surgery for others and, as a result, cut the elective surgery waiting list.
An evaluation of other OACCPs from pilot sites in NSW showed 11 per cent of patients waiting for a knee replacement removed themselves from the waiting list.
The Osteoporosis Re-Fracture Prevention Service (ORP) will be located in the same newly fitted-out space.
Osteoporosis is a chronic disease where the bones are slowly weakened over time. As a result, bones become fragile and are more likely to break after minimal injury, such as a simple trip and fall.
Osteoporosis Australia says more than one million Australians have the condition. It affects both men and women and is most common in adults over 50 years old. It can be treated, particularly if detected early.
Patients referred to the ORP service will have their bone health examined, a risk assessment about the likelihood of future falls or trips will be completed, and strategies to prevent future fractures will be implemented. Bone density testing will be available on site.
“Research shows that in about a half of all cases, a second fracture happens within two years of the initial one,” Jayne Hyde, the service’s Fracture Liaison Coordinator, said.
“Mortality as the result of a hip fracture is high – about five per cent of patients will die in hospital and up 20 per cent will die in the 12 months after the fracture occurs,” she said
Preventing falls is paramount and includes simple measures like patients having their eyesight checked, reviewing any medication and removing trip hazards at home.
The service will also offer information, education and support.
“We need to address the ‘osteoporosis care gap’ by promoting awareness about the importance of bone health and the management of osteoporosis, not only for patients and their families, but also GPs and other health professionals,” Jayne said.
“Because, despite the availability of effective and safe treatments, that can improve bone health and reduce the risk of fracture, osteoporosis remains underdiagnosed and undertreated.”
It’s hoped the ORP service will result in a drop in presentations at the emergency department and in hospital admissions and will also improve patients’ life expectancy.
Dr Marabani has worked at Canterbury Hospital for the past 25 years.
“Setting up this service is a pro-active step. Our hope is that we will prevent a sizable proportion of these on-going fractures. In fact, we’d like to ensure that a second fracture never happens,” she said.
Both of the new services are set to open later this year.