Management of Osteoarthritis
The Osteoarthritis Chronic Care Program (OACCP) is a coordinated multidisciplinary model of care that supports people with osteoarthritis of the hip and/or knee at all stages of the disease trajectory. While the model of care has been evaluated in hospital outpatient settings with people who are already on the waitlist for surgical hip or knee joint replacement, trials led by the ACI Musculoskeletal Network since have been undertaken in primary care settings with collaboration and partnership between local health districts and primary health networks. The evaluation indicates that OACCP is effective in consideration of improved patient outcomes and improved health system utilisation in outpatient settings. The interventions used to attain these results have been applied and trialled in various localities across NSW.
Osteoporotic Refracture Prevention
The Osteoporotic Refracture Prevention model of care was designed to guide best practice coordinated, multi-disciplinary care to improve outcomes for people with minimal trauma fracture, resulting in reduced refracture rates and the resultant health usage, morbidity and mortality that refracture causes. The key requirement is the development of Fracture Liaison Services (FLS) that can be coordinated from hospital out-patient or primary care settings, depending on the needs and willingness in local communities. FLS require the allocation of a health professional – often a senior nurse or physiotherapist – to coordinate the activities of the patient group, and access to a medical officer who can undertake the medical needs of the patients. The medical officer can be drawn from a range of hospital-based specialties or from general practice if contemporary evidence is consistently applied in that setting.
About the Musculoskeletal Initiatives
Integrated Local Musculoskeletal Service
This will be a trial conducted during the Leading Better Value Care initiative to determine if an integrated service can be implemented with a seamless service across primary and secondary care settings for people accessing the OACCP and the ORP. Rural and metropolitan sites are invited to work with ACI on how this could be delivered in their localities starting from a base that is depicted in the two diagrams.
The ACI would like to acknowledge the contribution of:
- the Northern Sydney LHD and PHN in the development of the metropolitan model
- the Murrumbidgee LHD and PHN in the development of the rural model.