Connecting Primary Care and Community Services: A New Framework for Comprehensive Osteoarthritis Care

Osteoarthritis affects 33.2 million US adults and drives substantial primary care utilization. Despite evidence supporting nonpharmacologic interventions, implementation remains challenging due to limited clinical-community coordination. We conducted a project in which we used existing evidence and developed an integrated primary care and community implementation framework for comprehensive osteoarthritis management through (1) landscape assessment; (2) expert panel input; (3) design sessions; and (4) iterative consultation. The resulting "Public Health Framework for Collaborative Osteoarthritis Management and Wellbeing" integrates existing clinical practice guidelines, electronic health record screening tools, structured referral pathways, and Community Care Hubs that coordinate access to evidence-based programs and social resources. This approach could serve as a model for managing other chronic conditions requiring clinical-community integration.