A critical review of clinical practice guidelines highlights the significance of patient-centered care for osteoarthritis management

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A systematic review of clinical practice guidelines (CPGs) conducted by Brooke Conley and his co-researchers noted patient-centered care involving exercise, education, and weight loss as the consistent recommendation in osteoarthritis (OA) management. The findings published in the recent issue of Arthritis Care & Research have also underscored the relevance of high-quality CPGs to improve patient outcomes.

In order to evaluate the quality of CPGs, the researchers reviewed four databases namely OvidSP MEDLINE, Cochrane, CINAHL, Embase and Physiotherapy Evidence Database, and four online guideline repositories. Out of 20 selected CPGs, 11 were deemed as high quality. Apart from patient-centered care; non-surgical care, nonsteroidal anti-inflammatory, and surgical interventions were recommended for disabling OA in patients refractory to non-surgical care. In addition, hand orthoses were recommended for patients with hand osteoarthritis.

In concordance with this study, a 2022 study also highlighted the relevance of high-quality CPGs on OA for the identification of best evidence for rehabilitation. This study is a part of ‘Best Evidence for Rehabilitation’ developed using WHO’s Package of Interventions for Rehabilitation. After a systematic search, the experts revealed patient education, exercise training, and weight reduction as the core treatment recommendations for knee and hip OA patients. The high-quality CPGs for OA care help physicians and patients to make appropriate decisions for any clinical condition.

In conclusion, the study findings highlight the need to have an adequate level of knowledge of OA CPGs regarding the importance of exercise and education by healthcare providers. It is also important to reduce the evidence-to-practice gap for the effective implementation of these recommendations.

References

  1. Conley B, Bunzli S, Bullen J, O’Brien P, Persaud J, Gunatillake T, Dowsey MM, Choong P, Lin I. What are the core recommendations for osteoarthritis care? A systematic review of clinical practice guidelines. Arthritis Care & Research. 2023 Feb 10.
  2. Oral A, Arman S, Tarakci E, Patrini M, Arienti C, Etemadi Y, Rauch A, Negrini S. A systematic review of clinical practice guidelines for persons with osteoarthritis. A “Best Evidence for Rehabilitation”(be4rehab) paper to develop the WHO’s Package of Interventions for Rehabilitation. International Journal of Rheumatic Diseases. 2022 Apr;25(4):383-93.