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Clinical guidelines

Guideline for the non-surgical management of hip and knee osteoarthritis - July 2009

General practice plays an important role within the Australian health care system in the prevention, early detection and management of chronic disease. The nature of general practice provides opportunity for early screening for chronic disease and the address of preventable risk factors. Musculoskeletal conditions, particularly osteoarthritis, represented some of the diseases most commonly managed by Australian general practitioners in 2003–2004, accounting for 17% of consultations. To manage chronic illness effectively requires well coordinated, patient centred care that is continuous, comprehensive and consistent. General practitioners are well placed to provide care and coordination, as well as to play a monitoring role, for the multidisciplinary management of chronic disease. The GP undertakes this role in consultation with other medical specialists as required. The role GPs play in chronic disease management through multidisciplinary care coordination and long term care planning is recognised within the national Medicare rebate framework. Patients with arthritis are eligible for broader funding arrangements under chronic disease management items for GP management plans and associated reviews.

As part of the federal government's Better Arthritis and Osteoporosis Care (BAOC) 2006–2007 budget initiative, guidelines for the management of arthritic conditions have been developed to inform evidence based primary care of chronic disease in general practice. Three guidelines focusing on osteoarthritis, rheumatoid arthritis and juvenile idiopathic arthritis have been developed.

This guideline on the management of osteoarthritis presents recommendations to assist GPs in managing patients with osteoarthritis. The guideline focuses on short term care; long term care planning and management; and coordination of multidisciplinary care needs. It is accompanied by algorithms and resources to assist in implementation of the recommendations.

Endorsement and expiry date for the recommendations

This guideline presents a comprehensive review of both pharmacological and nonpharmacological management of osteoarthritis within the Australian health care context, based on the best available evidence available up to July 2007. Evidence published after this date has not been reviewed for the guideline. Recommendations for the non-surgical management of hip and knee osteoarthritis was approved by the CEO of the National Health and Medical Research Council (NHMRC) on 23 February 2009, under section 14A of the National Health and Medical Research Council Act, 1992. Approval for the guidelines by the NHMRC is granted for a period not exceeding 5 years; after 5 years the approval expires. The NHMRC expects that the guideline will be reviewed, and revised if necessary, no less than once every 5 years. Readers should check with The Royal Australian College of General Practitioners (RACGP) for any reviews of, or updates to, this guideline.

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