Pharmacist Intervention Improves Knee Osteoarthritis Diagnosis and Treatment

Pharmacists can help identify patients with knee osteoarthritis and prompt them to begin treatment of the painful condition, a study suggests.

A collaborative care approach launched by pharmacists can help identify patients with knee osteoarthritis, encourage them to initiate treatment, and improve their joint function and quality of life, according to the results of a study published online on August 28, 2012, in Arthritis Care & Research.

The study included participants recruited by pharmacists in 32 pharmacies in Canada. All participants were aged 50 years or older, overweight, inactive, and experiencing pain, aching, or stiffness in or around the knees most days. Those with a history of osteoarthritis in other joints, recent knee injury, knee X-rays within the past 2 years, and those with gout, fibromyalgia, or other joint inflammations were excluded from the study.

In all, there were 139 participants in the study who were split into a usual care group (66 participants) and an intervention group (73 participants). Of the 32 pharmacies, 14 were designated as intervention therapy pharmacies and 18 as usual care pharmacies.

Participants in the intervention group received a one-on-one consult with a pharmacist that included education, medication review, and referral to a therapist-guided exercise program. Consultation outcomes that included the results of a screening questionnaire, medication recommendations, and referral to the guided exercise program were faxed to participants’ primary care providers. Pharmacists also followed-up with patients in the intervention group each month and reported pertinent information on pain, exercise, and medication to physicians, documenting a total of 355 comments from participants. Participants in the usual care group, meanwhile, received an educational packet on knee osteoarthritis from the Arthritis Society.

The researchers evaluated quality of care during participants’ regularly scheduled physician visits. Outcomes were assessed using the Arthritis Foundation’s indicators at baseline, 3 months, and 6 months. Those in the intervention group had a significantly higher overall quality indicator pass rate than those in the control group (difference of 45.2%) as well as higher pass rates on pain and functional assessment, exercise, education, weight loss, and knee radiographs. Participants in the intervention group also showed greater improvement on several pain and function scores at the 3- and 6-month interventions than those in the usual care group.