Osteoarthritis Health Professional Training Manual

Description

Osteoarthritis Health Professional Training Manual addresses current gaps in knowledge and the skills and confidence that are necessary to deliver evidence-based OA care that is consistent with international guidelines and for effective translation to clinical practice for health professionals. Written for health care professionals that meet patients with osteoarthritis in the clinic, like GPs, physiotherapists, rheumatologists, orthopedic surgeons, and MDs and PTs in training, medical students and basic researchers on osteoarthritis who want an update on the clinical aspects of OA, this book addresses the urgent need to improve health professional knowledge in managing patients with osteoarthritis. Front Cover Osteoarthritis Health Professional Training Manual Osteoarthritis Health Professional Training Manual Copyright Contents Contributors Preface 1 - Introduction to OA, communication, and person-centered care Introduction Section 1a: Etiopathogenesis and epidemiology of osteoarthritis What is osteoarthritis? How does osteoarthritis develop? How common is osteoarthritis? Impact and burden of osteoarthritis Section 1b: Communication skills that support best evidence osteoarthritis care and Section 1c: person-centered care What is best evidence osteoarthritis care? What is person-centered care? Compassionate communication Curious communication Critical communication Collaborative communication What are additional considerations in the uptake of best practice osteoarthritis care? Concluding remarks Key points Multi-choice questions References 2 - Module 2: history taking and physical assessment Brief introduction to the chapter History taking Introduction The importance of communication in eliciting accurate information A holistic approach to history taking Symptom assessment Participation restrictions Previous medical history Comorbidities Psychological factors Sleep and fatigue Support network Attitudes and beliefs Screening for red flags Use of recognized person reported outcome measures Goal setting Key elements of documentation Summary Physical assessment Introduction Preparing for and undertaking the physical assessment Content of the physical examination Look General observation Joint specific observation Gait observation Feel Palpation Move Range of motion assessment Measure Muscle strength and length/tightness Neurological features Special tests Specific content for physical examination of the knee, hip, and wrist/hand Knee examination Special tests for the knee Hip examination Special tests for the hip Wrist/hand examination Special tests for the hands Summary Clinical practice points Concluding remarks References 3 - Diagnosis, risk factors for OA development and progression, OA prevention, and recognizing comorbidities Introduction OA incidence Impact of OA OA diagnosis Clinical diagnosis Early-stage OA Use of additional diagnostics by imaging or laboratory tests Holistic approach Risk factors Age Sex Race/ethnicity Overweight/obesity Joint injury, habitual and occupational physical activities Nutritional factors Vitamin D Vitamin K Selenium Dietary fiber Bone mineral density Joint shape and alignment Muscle strength Genetics Risk factors for symptomatic OA OA prevention Primary prevention Preventing knee injury Interventions after knee injury Interventions for hip dysplasia Interventions for cam deformity or FAIS Secondary prevention OA and comorbidities References 4 - Core components of best evidence OA care: management planning, education, supporting self-management and behavi ... Introduction to core components of best evidence OA care Key components of best evidence OA care Brief summary of evidence supporting core components of best evidence OA care Education and support for self-management Increasing physical activity and exercise Weight management A comprehensive approach to osteoarthritis management Utilizes a biopsychosocial approach and perspective Interdisciplinary coordinated care Key elements: self-efficacy, goals, strengths and available resources, and behavior change techniques Self-efficacy Goal-driven Considers individual strengths and available resources Incorporates a range of behavior change techniques Approaches to monitoring treatment progress and adjusting management plans Regular monitoring Use validated psychosocial tools to aid in assessment and to support monitoring Regularly review plan and adjust Purpose and importance of education and support for self-management Self-management support strategies Responding to emotions Need for a framework Behavior change: why should we use a theoretical framework? Common elements of behavior change theory A social cognitive framework: social cognitive theory Promoting self-efficacy: the central element Feedback loops: relationship among past behavior, self-efficacy, and performance Case study Background information Relationship building and assessment Soliciting the main concern Using a social cognitive framework – intervention Follow-up and evaluation References 5 - Physical activity, exercise, and therapeutic exercise What is physical activity, sedentary behavior, exercise, and therapeutic exercise? Recommendations for physical activity in OA Consequences of physical inactivity and sedentary behavior in OA Types of exercises that are beneficial for people with OA Cardiovascular (aerobic) fitness Resistance (strength) training Flexibility (stretching) exercise Neuromotor (neuromuscular) exercise Mind-body exercise Counselling-based physical activity promotion Mechanisms of exercise benefits Safety of physical activity and therapeutic exercise Principles of exercise prescription and progression for OA Overcoming barriers to physical activity and exercise participation Services and supports to facilitate engagement in physical activity and exercise for people with OA Increasing adherence to home exercise Activity pacing and behavioral graded activity for people with OA References 6 - Module 6: core components of best evidence OA care – weight control AIMS A brief introduction to the chapter Effect of weight control in OA pain management and OA disease progression Overweight or obesity is a strong risk factor for OA Mechanisms of body weight contributing to the development and progression of OA Benefits of weight loss in OA Other benefits of weight loss Diet and OA: Summary of dietary components and their effects on the prevention and management of OA Diet and weight loss Antiinflammatory diets Dietary components Meal replacement and low caloric diets Patient-centered weight control to manage OA How can we best support people with OA to lose body weight? How to maintain weight loss? Safety considerations Barriers to implementing weight control in persons with OA Overall factors for weight loss Patient level Lack of motivation to lose weight or change habits Pain as a barrier to losing weight and exercise Healthy eating Clinician level Lack of communication from healthcare providers Guideline adherence Lack of time (patients and clinicians) Concluding remarks Selected links to any helpful online resources Europe US Asia Australia Africa Case study 3: Katrina References 7 - Module 7: adjunctive rehabilitative interventions Introduction to adjunctive rehabilitative interventions Biomechanical devices and strategies Varus/valgus unloader braces Patellofemoral bracing Hip bracing Medial and lateral wedges or insoles Footwear Walking poles Gait retraining Electrical stimulation for pain management Classic rehabilitation approaches Manual therapy Taping Assistive devices Thermal modalities Complementary alternative medicine Yoga and pilates Tai chi and acupuncture Psychosocial strategies Summary and concluding remarks References 8 - Pharmacotherapy Aims for module Role and rationale of pharmacotherapy in OA management Oral medications Acetaminophen (paracetamol) Nonsteroidal antiinflammatory drugs (NSAIDs) Mechanism of action Adverse effects – all NSAIDs Adverse effects – contrasts between nonselective NSAIDs and COX-2 selective NSAIDs Key points Opioids Adjuvant analgesics Topical therapies Capsaicin Topical NSAIDS Intraarticular therapies Corticosteroids Hyaluronan products Platelet-rich plasma Stem cell therapy Dextrose prolotherapy Key points Dietary supplements/nutraceutical products Glucosamine sulfate Chondroitin Fish oil/krill oil Vitamin D Vitamin K Avocado soybean unsaponfiables (ASU) Collagen Methylsulfonylmethane (MSM) Tumeric/curcumin Boswellia serrata Pycnogenol Key points Experimental therapies Concluding remarks References 9 - Surgery for osteoarthritis Indications for surgery Surgical options for osteoarthritis Procedures for hip osteoarthritis Total hip replacement Pelvic osteotomy Procedures for knee osteoarthritis Total knee replacement Unicompartmental knee replacement Patellofemoral replacement High tibial osteotomy Risks of surgery General Specific risks related to total joint replacement Preoperative preparation General fitness Comorbidities Infections Anesthetic and postoperative pain relief Postoperative course In hospital – Early Recovery After Surgery (ERAS) First 6weeks First 12months Measuring outcomes Patient expectations and satisfaction Acknowledgments References 10 - The interprofessional team, service delivery, and professional development Introduction Principles underpinning successful delivery of care Support for self-management of osteoarthritis Person-centered care The Chronic Care Model Interprofessional and multidisciplinary care Exploring health and nonhealth considerations for delivering care The healthcare team Who should be delivering osteoarthritis care? The role of the health professionals in delivering osteoarthritis care When should we on-refer patients to other professionals? Delivering and coordinating osteoarthritis care Phase i. Education and understanding Person-centered care considerations Clinical assessments Phase ii. Planning and goal setting Treatment domains Independent self-management options Phase iii. Ongoing support and treatment progression Phase iv. Long-term joint health Thinking beyond health care—integrating care into everyday life What are social determinants of health? Concepts underpinning social determinant considerations for osteoarthritis care Pathways of care and adapting them to suit different settings Enhancing osteoarthritis care in lower-resourced settings Incorporating evidence-based care into your clinical practice Using the evidence pyramid (levels of evidence) in evidence-based care Top tier evidence to guide decision-making Other reliable sources of information In closing… References Index A B C D E F G H I J K L M N O P R S T U V W Y Back Cover