Improving osteoarthritis detection in the community: Pharmacist identification of new, diagnostically confirmed osteoarthritis

Authors

  • Carlo A. Marra,

    Corresponding author
    1. Collaboration for Outcomes Research and Evaluation, University of British Columbia, Centre for Clinical Epidemiology and Evaluation, and Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
    • Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, 717-828 West 10th Avenue, Vancouver, British Columbia, Canada V521L8
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    • Dr. Marra's work was supported by a Government of Canada Research Chair in Pharmaceutical Outcomes, Scholar Awards from the Michael Smith Foundation for Health Research, and the Canadian Arthritis Network.

  • Jolanda Cibere,

    1. University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada
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    • Dr. Cibere's work was supported by a J. W. McConnell Family Foundation Scholar award and a Canadian Institutes of Health Research Clinical Scientist award.

  • Ross T. Tsuyuki,

    1. Epidemiology Coordinating and Research Centre and University of Alberta, Edmonton, Alberta, Canada
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    • Dr. Tsuyuki's work was supported by the Merck Frosst Chair in Patient Health Management and Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta.

  • Judith A. Soon,

    1. Community Pharmacy Research Network, Collaboration for Outcomes Research and Evaluation, and University of British Columbia, Vancouver, British Columbia, Canada
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  • John M. Esdaile,

    1. University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada
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  • Louise Gastonguay,

    1. Collaboration for Outcomes Research and Evaluation and University of British Columbia, Vancouver, British Columbia, Canada
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  • Bridgette Oteng,

    1. Collaboration for Outcomes Research and Evaluation and University of British Columbia, Vancouver, British Columbia, Canada
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  • Patrick Embley,

    1. Mary Pack Arthritis Centre, Vancouver General Hospital, Vancouver, British Columbia, Canada
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  • Lindsey Colley,

    1. Collaboration for Outcomes Research and Evaluation and University of British Columbia, Vancouver, British Columbia, Canada
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  • Gilbert Enenajor,

    1. University of Alberta, Edmonton, Alberta, Canada
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  • Roelof Kok

    1. University of Utrecht, Utrecht, The Netherlands
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  • Presented in part at the 70th Annual Scientific Meeting of the American College of Rheumatology, Washington, DC, November 2006.

Abstract

Objective

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.

Methods

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.

Results

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/m2) in 29%, overweight (25.0–29.9 kg/m2) in 45%, and obese (>30.0 kg/m2) 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.

Conclusion

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.

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