• News New Blog Banner

  • COAMI Recommends Treating OA as a Chronic Disease

    Osteoarthritis (OA) should be considered—and treated—in a more multidisciplinary, coordinated, and prevention‐oriented way, similar to other chronic diseases, says a call to action recently issued by the Chronic Osteoarthritis Management Initiative (COAMI), a program of the United States Bone and Joint Initiative (USBJI).   

    The COAMI work group met in May to assess current practice in the management of osteoarthritis. Work group members included physical therapists; orthopedic nurses and surgeons; specialists in rheumatology, rehabilitation, and sports medicine; osteopathic physicians; and athletic trainers.

    Changing the paradigm of intervention for OA, especially among health care providers, was a primary focus of the meeting. OA should be "subject to screening for risk factors, prevention‐oriented interventions, ongoing monitoring, and comprehensive care models typical of other chronic diseases. Instead, many patients and health care providers tolerate and expect pain and disability as an inevitable trajectory of OA and aging," says COAMI.

    In addition, the work group identified 7 priority actions to undertake, with the help of partners in other organizations who share COAMI's goals for improved patient outcomes.

    The priority actions are:

    • developing a call to action geared specifically to health care professionals who treat patients with OA, as well as policymakers and the public;
    • convening a larger conference that leads to further recommendations that would build agreement across disciplines and specialties within the health care system, so that current inconsistencies in approach could be resolved, and models of care developed;
    • reaching out to other partners beyond the Work Group members (both existing and new) to include them in future COAMI work;
    • exploring standardized screening tools and indicators of OA to make early diagnosis both more consistent and more likely;
    • developing tools and prompts that promote patient engagement in learning about and managing OA (especially before symptoms become debilitating);
    • lending COAMI's support to existing advocacy and awareness efforts that are already underway; and
    • developing and supporting an OA-specific research agenda that would fill gaps in evidence and practice.

    APTA is a founding member of the USBJI and serves on its board of directors.  

    Yearly Costs of Chronic Pain Exceed Those of Cancer, Heart Disease, and Diabetes

    The annual cost of chronic pain is as high as $635 billion a year, which is more than the yearly costs for cancer, heart disease, and diabetes, say health economists from Johns Hopkins University in this month's The Journal of Pain.

    The researchers estimated the annual economic costs of chronic pain in the United States by assessing incremental costs of health care due to pain and the indirect costs of pain from lower productivity. They compared the costs of health care for people with chronic pain with those who do not report chronic pain. The authors defined people with pain as those who have pain that limits their ability to work, are diagnosed with joint pain or arthritis, or have a disability that limits capacity for work.

    Data from the 2008 Medical Expenditure Panel Survey was used to gauge the economic burden of pain. The sample included 20,214 individuals 18 and older to represent 210.7 million US adults.

    Results showed that mean health care expenditures for adults were $4,475. Prevalence estimates for pain conditions were 10% for moderate pain, 11% for severe pain, 33% for joint pain, 25% for arthritis, and 12% for functional disability. Persons with moderate pain had health care expenditures $4,516 higher than someone with no pain, and individuals with severe pain had costs $3,210 higher than those with moderate pain. Similar differences were found for other pain conditions: $4,048 higher for joint pain, $5,838 for arthritis, and $9,680 for functional disabilities.

    Also, adults with pain reported missing more days from work than people without pain. Pain negatively impacted 3 components of productivity—work days missed, number of annual hours worked, and hourly wages.

    Based on their analysis of the data, the authors determined that that the total cost for pain in the United States ranged from $560 to $635 billion. Total incremental costs of health care due to pain ranged from $261 to $300 billion, and the value of lost productivity ranged from $299 to $334 billion. Compared with other major disease conditions, the per-person cost of pain is lower but the total cost is higher.

    The authors noted their conclusions are conservative because the analysis did not consider the costs of pain for institutionalized and noncivilian populations, for persons under 18, and for caregivers.