Marra Carlo A, Cibere Jolanda, Tsuyuki Ross T, Soon Judith A, Esdaile John M, Gastonguay Louise, Oteng Bridgette, Embley Patrick, Colley Lindsey, Enenajor Gilbert, Kok Roelof
Collaboration for Outcomes Research and Evaluation, University of British Columbia, Centre for Clinical Epidemiology and Evaluation, British Columbia, Canada.
Arthritis Rheum. 2007 Oct 15;57(7):1238-44. doi: 10.1002/art.23019.
Osteoarthritis (OA) is the most common arthritis and a leading cause of disability. Many persons with knee OA are not diagnosed and not referred for treatment. Therefore, identification of patients with knee pain who have undiagnosed OA needs to be improved. Our objective was to determine if pharmacists, using a simple screening questionnaire, can identify individuals with previously undiagnosed knee OA.
Patients with knee pain and no previous diagnosis of knee OA were recruited by community pharmacists who used a simple questionnaire (<10 minutes to complete) to determine likelihood of knee OA. Patients who were likely to have knee OA were referred for a standardized knee examination and radiograph.
Of the 411 patients screened by pharmacists, 274 were eligible. Of these, 44 declined, 35 were ineligible (18 had a previous OA diagnosis,16 had other inflammatory conditions, and 1 was excluded for other reasons), and 1 died. The remaining 194 were mostly female (62%) with a mean age of 62 years and were mostly white (86%). Body mass index (BMI) was classified as normal (18.5-24.9 kg/m(2)) in 29%, overweight (25.0-29.9 kg/m(2)) in 45%, and obese (>30.0 kg/m(2)) in 26%. Of those examined, 190 (98%) of 194 met the American College of Rheumatology clinical criteria for knee OA. The radiographic results revealed that most participants likely had mild OA.
Pharmacists administering a simple screening questionnaire can identify >80% of patients with knee pain who have undiagnosed knee OA. Based on radiographs and BMI, much of this OA is early and may be amenable to intervention.
骨关节炎（OA）是最常见的关节炎，也是导致残疾的主要原因。许多膝骨关节炎患者未被诊断出来，也未得到转诊治疗。因此，需要改进对有膝痛但未被诊断出骨关节炎患者的识别。我们的目的是确定药剂师使用简单的筛查问卷能否识别出之前未被诊断出膝骨关节炎的个体。
社区药剂师招募有膝痛且之前未被诊断出膝骨关节炎的患者，使用一份简单问卷（完成时间<10分钟）来确定膝骨关节炎的可能性。可能患有膝骨关节炎的患者被转诊进行标准化的膝关节检查和X光检查。
药剂师筛查的411名患者中，274名符合条件。其中，44名拒绝参与，35名不符合条件（18名曾被诊断为骨关节炎，16名有其他炎症性疾病，1名因其他原因被排除），1名死亡。其余194名大多为女性（62%），平均年龄62岁，大多为白人（86%）。体重指数（BMI）分类为正常（18.5 - 24.9 kg/m²）的占29%，超重（25.0 - 29.9 kg/m²）的占45%，肥胖（>30.0 kg/m²）的占26%。在接受检查的患者中，194名中的190名（98%）符合美国风湿病学会膝骨关节炎临床标准。X光检查结果显示，大多数参与者可能患有轻度骨关节炎。
药剂师使用简单的筛查问卷能够识别出80%以上有膝痛但未被诊断出膝骨关节炎的患者。根据X光检查和BMI结果，这些骨关节炎大多处于早期，可能适合进行干预。
