Department of Medicine, Thurston Arthritis Research Center, University of North Carolina, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599-7280, USA; Center for Health Services Research in Primary Care, Department of Veterans Affairs Medical Center, Durham, NC, USA.
Department of Orthopaedics and The University of Melbourne, Level 2, Clinical Sciences Building, 29 Regent Street, Fitzroy, 3065, Victoria, Australia; Department of Surgery, St. Vincent's Hospital Melbourne, Level 2, Clinical Sciences Building, 29 Regent Street, Fitzroy, 3065, Victoria, Australia.
Best Pract Res Clin Rheumatol. 2016 Jun;30(3):503-535. doi: 10.1016/j.berh.2016.09.003.
Osteoarthritis (OA) is a leading cause of pain and disability worldwide. Despite the existence of evidence-based treatments and guidelines, substantial gaps remain in the quality of OA management. There is underutilization of behavioral and rehabilitative strategies to prevent and treat OA as well as a lack of processes to tailor treatment selection according to patient characteristics and preferences. There are emerging efforts in multiple countries to implement models of OA care, particularly focused on improving nonsurgical management. Although these programs vary in content and setting, key lessons learned include the importance of support from all stakeholders, consistent program delivery and tools, a coherent team to run the program, and a defined plan for outcome assessment. Efforts are still needed to develop, deliver, and evaluate models of care across the spectrum of OA, from prevention through end-stage disease, in order to improve care for this highly prevalent global condition.
骨关节炎(OA)是全球范围内导致疼痛和残疾的主要原因。尽管存在基于证据的治疗方法和指南,但 OA 管理的质量仍存在很大差距。在预防和治疗 OA 方面,行为和康复策略的应用不足,也缺乏根据患者特点和偏好来选择治疗方法的流程。许多国家正在努力实施 OA 护理模式,特别是侧重于改善非手术管理。虽然这些方案在内容和设置上有所不同,但吸取的主要经验教训包括所有利益相关者的支持、方案的持续交付和工具、运行方案的协调一致的团队以及明确的结果评估计划的重要性。仍需要努力开发、提供和评估从预防到终末期疾病的 OA 护理模式,以改善这种高发性全球疾病的护理。