1. A New Vision for Chronic Osteoarthritis Management A Call to Action from the Chronic Osteoarthritis Management Initiative (COAMI)

2. What is COAMI?  A Work Group representing:  Health care professionals who treat patients with osteoarthritis (OA)  orthopaedic nurses and surgeons  specialists in rheumatology, rehabilitation and sports medicine  osteopathic physicians  physical therapists  athletic trainers  Providers who may not specialize in OA, but see patients at risk  Pediatricians and pediatric nurses, family physicians, nurse practitioners, physician assistants  Epidemiologists and researchers studying OA  People with arthritis and the Arthritis Foundation

3. The Burden of OA  OA is prevalent  Most common type of arthritis, affecting 27 million Americans (and 10% of adults)  OA is disabling  Significant cause of disability and pain  Interferes with work and activity levels  Undermines physical activity levels recommended for weight loss and controlling other chronic diseases  OA is co-occurring  Over half (52 percent) of patients with diagnosed diabetes also have OA  OA is costly  $42.3 billion spent on 905,000 knee and hip replacements in 2009 alone

4. Missed Opportunities to Approach OA as a Chronic Disease

5. A Vision for the Future Not every case of OA can be prevented, but a significant degree of the pain and disability caused by OA can and should be prevented or ameliorated.

6.  Treat OA as a chronic disease  Adopt best practices of other successful chronic disease models  Ask patients about joint pain, mobility, and function  Reinforce and support weight management, physical activity, and pain management A Unique Role for Health Care Professionals

7. What Will It Take? COAMI Recommendations  Develop an OA Call to Action, specifically geared to health care professionals  Convene an OA Management Conference of Health care providers  Identify areas of agreement and gaps  Review models of care  Develop a research agenda and priorities  Reach out to other partners to include them in future COAMI work (COAMI and USBJI represented in OAAA)

8. What Will It Take? COAMI Recommendations (Continued)  Explore standardizing screening tools and indicators of OA, to make early diagnosis more consistent and likely such as the  E.g., AF risk assessment of OA of the knee and the Fracture Risk Assessment Tool (FRAX) model  Develop tools and prompts that promote patient engagement in learning about and managing OA (and pre-OA)  E.g., OA Action Alliance Materials, Exercise is Medicine™

9. What Will It Take? COAMI Recommendations (Continued)  Lend COAMI’s support to existing advocacy and awareness efforts of the OA Action Alliance and others and seek specific opportunities to reinforce key messages:  OA should be managed as a chronic disease  “Pre-OA” (like pre-diabetes) could be identified and addressed more systematically by health care providers  Health care providers should support and motivate patients to become more physically active, prevent injury where possible, seek self management and maintain a healthy weight

10. What Will It Take? COAMI Recommendations (Continued)  Develop and support an OA-specific research agenda to fill gaps in evidence and practice  Managing patients with mild to moderate symptoms and limitations  Identifying and tracking OA risk factors (e.g., using Electronic Medical Records)  Educating clinicians about musculoskeletal conditions and OA

11. OAAA and COAMI Collaboration  COAMI aims to coordinate the health care professional’s role in the management of OA  OAAA aims to deliver public health awareness messages through its membership  Drive people with pre-OA and OA to a more coordinated approach to the medical management of OA  What other ways can our organizations together support COAMI’s and OAAA’s recommendations?