Osteoarthritis Health Impact and Treatment

Nursing Care and Impact of Osteoarthritis

What is Osteoarthritis,Impact of Osteoarthritis on Cost,Treatment Approaches,Disease Self Management,Prevalence of Disease.

What is Osteoarthritis

    Osteoarthritis, the most common of the rheumatic diseases, is characterized by progressive loss of articular cartilage and by reactive changes at the margins of the joints and in subchondral bone. 

    Clinical features may include pain in the joint involved, which is typically worse with activity and relieved by rest; stiffness after periods of immobility; enlargement of the joint; instability; limitation of motion; and functional impairment. 

    Depending on the absence or presence of an identifiable local or systemic etiological factor, osteoarthritis has been classified into idiopathic (primary) and secondary forms. Classification of the disease is based on various combinations of clinical, radiographic, and laboratory parameters. 

    The prevalence of osteoarthritis is strikingly correlated with age; it is uncommon in adults under 40, but it is the number-one chronic disease in late life, with more than 80% of those over the age of 75 being affected. 

    Osteoarthritis is a major cause of disability in older adults, and knee osteoarthritis is more likely to result in disability than ostcoarthritis of any other joint. However, the prevalence of osteoarthritis at all joint sites increases progressively with age, which is the most powerful risk factor for the disease. 

     are about twice as likely as men to be affected, and African-American women are twice as likely as Caucasian women to have knee osteoarthritis. The pattern of joint involvement also differs with sex: women have a greater number of joints involved and more frequent complaints of morning stiffness, joint swelling, and nocturnal pain.     

    Factors that appear to be associated with osteoarthritis, based on cross-sectional and longitudinal studies, include obesity, bone density, trauma and repetitive stress, and generic factors.

Impact of Osteoarthritis on Cost

    The impact of osteoarthritis on function and costs of care are substantial. Patients with osteoarthritis are more likely to be limited in the amount and kind of major activities they can perform, have more restricted bed days, and are more likely to report disability. 

    When disease prevalence figures were applied to estimates of health care utilization and disability for both rheumatoid arthritis and osteoarthritis, an aggregate economic impact some 30-fold greater was found for osteoarthritis than for rheumatoid arthritis. 

    In addition to the functional disability and economic impact of osteoarthritis, older people with this disease experience an inordinate amount of suffering, depression, and diminished quality of life.

Treatment Approaches

    Treatment approaches to patients with osteoarthritis have been mainly pharmacological, usually combined with physical therapy and sometimes surgery. Although these interventions are useful, they often fail to control disease progression, and symptoms may be associated with high costs and many toxicities. 

    In addition, they frequently fail to address important issues of patient concern, such as psychological stress, quality of life, and autonomy. Because of the chronicity of the disease, patients must learn to manage and cope with osteoarthritis on a day-to-day basis. 

    The ability to succeed in this task differentiates those who are incapacitated from those who continue to lead full and active lives in the face of equal disease severity. For this reason, health education has a potentially important role.

Disease Self Management 

    One of the most common educational interventions used for chronic disease is self-management. Self-management has been described as the day-to-day tasks an individual must undertake to control or reduce the impact of disease on health status; it includes all the tasks for handling clinical aspects of the disease away from the hospital or physician's office. 

    For persons with osteoarthritis this may include using medications, managing acute episodes and emergencies, maintaining adequate exercise and activity, using relaxation and stress reducing techniques, seeking information, using community services, adapting to work, managing relations with significant others, and managing emotions and psychological responses to the illness.

Prevalence of Disease

    The “graying of America” and its concomitant increase in the prevalence of osteoarthritis poses problems for an ever-spiraling health care budget. Incurable by definition, management of osteoarthritis extends over time, creating continuous costs to both patient and provider. 

    It is important that we examine innovative ways to deliver high quality care for older adults with osteoarthritis in as efficacious and economical a manner as possible.