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Management of osteoarthritis and cardiovascular disease risk (EPOSTER: 5mins)

Presentation Description

Background:  Osteoarthritis (OA) of hip and/or knee and cardiovascular disease (CVD) risk are both commonly managed issues in general practice with known research translation gaps. Our aims were to assess alignment of current GP management of CVD risk and OA (hip/knee) with current Australian guidelines. 
 
Method: Two sub-studies of OCEAN study, a national, cross-sectional study of GP clinical activity where GPs record details of 100 consecutive encounters with consenting patients. Each GP answered questions about management of OA (hip/knee) for 30 encounters, and on CVD risk for 30 encounters.
 
Results: Of 30 GPs, 14 completed both sub-studies, providing responses for 247 patients aged 40+ for the OA study and 193 patients aged 45-74 for the CVD study. 
 
OA hip/knee patients were primarily managed with advised physical activity (83.3%/76.9%), weight management advice (33.3%/23.1%) and physiotherapist referrals (41.7%/46.2%). Few were managed with knee arthroscopies, opioids or glucosamine. The main concern was the use of x-rays in patients without severe symptoms.
 
Only one patient was deemed at high CVD risk by their GP, yet 12 patients were taking cholesterol medication and 22 were taking antihypertensive medications, suggesting possible misalignment between prescribing and CVD risk guidelines. Formal assessment of CVD risk was performed for only 15.3% of recommended patients in the previous 2 years.
 
Discussion: Apart from questionable use of x-rays, overall GP clinical care of osteoarthritis of the knee and/or hip aligned with RACGP guidelines. 

The low rate of formal CVD risk assessment may be due to missing blood pressure (BP) and cholesterol levels as GPs did not record BP and/or cholesterol levels for 44.4% of targeted patients.
 
Implications for practice: Access to BP and cholesterol levels may increase CVD risk assessments. More testing, improved recording and/or retrieval of test results may be required. Further education/awareness may align x-ray use with guidelines.

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