Improving osteoarthritis detection in the community: pharmacist identification of new, diagnostically confirmed osteoarthritis.
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/m(2)) in 29%, overweight (25.0-29.9 kg/m(2)) in 45%, and obese (>30.0 kg/m(2)) 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.


CONCLUSIONS
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.
Marra
Carlo A
CA
Collaboration for Outcomes Research and Evaluation, University of British Columbia, Centre for Clinical Epidemiology and Evaluation, British Columbia, Canada. carlo.marra@ubc.ca
Cibere
Jolanda
J
Tsuyuki
Ross T
RT
Soon
Judith A
JA
Esdaile
John M
JM
Gastonguay
Louise
L
Oteng
Bridgette
B
Embley
Patrick
P
Colley
Lindsey
L
Enenajor
Gilbert
G
Kok
Roelof
R
D000368:Aged; D001955:British Columbia; D003157:Community Pharmacy Services; D005260:Female; D006302:Health Services Research; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis*; D010595:Pharmacists; D024382:Professional Role; D011795:Surveys and Questionnaires