Medical aspects of the multidisciplinary assessment and management of osteoarthritis

Osteoarthritis, the most common form of arthritis, influences a person's mental well-being, ability to work or perform activities of daily living, and personal and family relationships. Ideally, the management of this disease is multidisciplinary, involving not only the use of medication but also exercise instruction, dietary counseling, and psychosocial interventions. The effects of such a comprehensive treatment program have not been well studied. A 12-week trial of multidisciplinary assessment and management of osteoarthritis was conducted. In addition to receiving the anti-inflammatory agent sulindac, patients were evaluated and followed up by health professionals in the disciplines of medicine, physical therapy, occupational therapy, nutrition, social work, and psychology. An initial assessment of the degree of pain, swelling, tenderness, stiffness, and ability to conduct activities of daily living was made, which represented patients' entry status. Subsequent assessments were made by the multidisciplinary team every two weeks for 12 weeks. Seventy-seven patients completed at least ten of the 12 weeks. On entering the study, two thirds of the patients had pain, tenderness, or swelling affecting the hip, knee, or hand. At the end of 12 weeks, 80% of the patients had improvement in their osteoarthritis, and 71% improved in their ability to conduct activities of daily living. The results support the view that a comprehensive approach to osteoarthritis can significantly reduce disability and pain.