Algorithm for the clinical management of osteoarthritis in the family health strategy
Algoritmo para manejo clínico de osteoartrite na estratégia de saúde da família
Resumo
Objectives: To develop an effective algorithm for the clinical management of osteoarthritis in the family health strategy, aiming to improve early diagnosis, appropriate treatment, and the quality of life of patients. Methods: Qualitative study where primary care physicians were invited to respond to a questionnaire regarding personal aspects of the professionals, as well as technical knowledge on the diagnosis and follow-up of osteoarthritis. Results: The profile of the general practitioner in Teresina's Family Health Strategy (ESF) is a younger professional (<50 years old), with more than 5 years of experience in primary care, who regularly undergoes scientific updates, and feels capable of diagnosing osteoarthritis using simple imaging exams. They identify the lack of health promotion programs and multidisciplinary teams as challenges in the diagnosis and follow-up of these patients. They consider projects aimed at health promotion for these patients and the development of osteoarthritis management protocols specifically for primary care to be of utmost importance. Conclusion: Due to the high incidence of referrals to specialists, it is of paramount importance to implement clinical management algorithms for osteoarthritis in primary care.
Downloads
Referências
ABRAMOFF, B.; CALDERA, F. E. Osteoarthritis: Pathology, Diagnosis, and Treatment Options. Medical Clinics of North America, v. 104, n. 2, p. 293-311, Mar. 2020. DOI: 10.1016/j.mcna.2019.10.007. Epub 2019 Dec 18. PMID: 32035570.
BALDWIN, J. et al. An osteoarthritis model of care should be a national priority for New Zealand. New Zealand Medical Journal, v. 130, n. 1467, p. 78-86, Dec. 2017.
BERENBAUM, F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis and Cartilage, v. 21, n. 1, p. 16-21, 2013.
BRUYÈRE, O. et al. A consensus statement on the European Society for Clinical and Economic aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for management of knee osteoarthritis - from evidence-based medicine to the real-life setting. Seminars in Arthritis and Rheumatism, v. 45, n. 4 suppl, p. S3-S11, 2016.
CHIEREGHIN, E.; MARTINEZ. Análise das condições para diagnóstico de doenças reumáticas na atenção básica de saúde na cidade de Sorocaba-SP. Revista Brasileira de Reumatologia, v. 55, n. 3, p. 251-255, 2015.
DZIEDZIC, K. et al. Implementing the NICE osteoarthritis guidelines: a mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care - the management of osteoarthritis in consultations (MOSAICS) study protocol. Implementation Science, v. 9, p. 95, 2014.
EDWARDS, J. J.; KHANNA, M.; JORDAN, K. P.; JORDAN, J. L.; BEDSON, J.; DZIEDZIC, K. S. Quality indicators for the primary care of osteoarthritis: a systematic review. Annals of the Rheumatic Diseases, v. 74, n. 3, p. 490-498, 2015. DOI: 10.1136/annrheumdis-2013-203913.
EGERTON, T. et al. A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians' barriers and enablers to the management of osteoarthritis. Osteoarthritis and Cartilage, v. 25, n. 5, p. 625-638, 2017a. DOI: 10.1016/j.joca.2016.12.002.
EGERTON, T. et al. General practitioners' perspectives on a proposed new model of service delivery for primary care management of knee osteoarthritis: a qualitative study. BMC Family Practice, v. 18, p. 85, 2017b. DOI: 10.1186/s12875-017-0656-7.
FINNEY, A. et al. Multidisciplinary approaches to managing osteoarthritis in multiple joint sites: a systematic review. BMC Musculoskeletal Disorders, v. 17, p. 266, 2016.
JACKSON, H. et al. Patterns of routine primary care of osteoarthritis in the UK: a cross-sectional electronic health records study. BMJ Open, v. 7, p. e019694, 2017. DOI: 10.1136/bmjopen-2017-019694.
KATZ, J. N. et al. Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA, v. 325, n. 6, p. 568-578, Feb. 2021. DOI: 10.1001/jama.2020.22171. PMID: 33560326; PMCID: PMC8225295.
KJIANG, Y. Osteoarthritis year in review 2021: biology. Osteoarthritis and Cartilage, v. 30, n. 2, p. 207-215, Feb. 2022. DOI: 10.1016/j.joca.2021.11.009. Epub 2021 Nov 18. PMID: 34801671.
MATA, M. S.; COSTA, F. A.; SOUZA, T. O.; MATA, Á. N. S.; PONTES, J. F. Dor e funcionalidade na atenção básica à saúde [Pain and functionality in primary health care]. Ciência & Saúde Coletiva, v. 16, n. 1, p. 221-230, jan. 2011. DOI: 10.1590/s1413-81232011000100025. PMID: 21180830.
PARKINS, et al. Comparison of patient experience of the Osteoarthritis consultation with GP attitudes and beliefs to AO: a narrative review. BMC Family Practice, v. 15, p. 46, 2014.
PETROSYAN, Y. et al. Quality indicators for care of osteoarthritis in primary care settings: a systematic literature review. Family Practice, v. 18, p. 85, 2017. DOI: 10.1186/s12875-017-0656-7.
POECHERET, M. et al. Enhancing delivery of osteoarthritis care in the general practice consultation: evaluation of a behaviour change intervention. BMC Family Practice, v. 19, p. 26, 2018.
QUICKE, J. G. et al. Osteoarthritis year in review 2021: epidemiology & therapy. Osteoarthritis and Cartilage, v. 30, n. 2, p. 196-206, Feb. 2022. DOI: 10.1016/j.joca.2021.10.003. Epub 2021 Oct 22. PMID: 34695571.
YU, D.; JORDAN, K.P.; BEDSON, J.; ENGLUND, M.; BLYTH, F.; TURKIEWICX, A.; et al. Population trends in the incidence and initial management of osteoarthritis: age-period-cohort analysis of the Clinical Practice Research Datalink, 1992–2013. Rheumatology, v. 56, n. 11, p. 1902-1917, Nov. 2017. DOI: 10.1093/rheumatology/kex270.
