June 25, 2019
The education evening on ‘Osteoarthritis – Joint Management with General Practice’, is an example of how Northern Health is working collaboratively with the General Practitioner (GP) for the best patient outcome. It was initiated by our Orthopaedic Department and developed and coordinated through the Primary Care Liaison Unit.
Seventeen GP’s attended the event, which sought to provide a forum for GP education regarding best practice non-surgical management of hip and knee osteoarthritis (exercise and medication).
Karen Overall’s role as Primary Care Liaison, is to provide the expertise of Northern Health’s medical specialists to present the most up-to-date and relevant medical development for the GP. A role that is of increasing importance in Northern Health’s mission to keep our community well in their own homes.
“An important aspect of the upskilling is to know at what point to refer to Northern Health and what is required in the referrals for triage,” says Karen.
“Patients are triaged according to the information we receive, so it’s really important to educate the GP on what is required on a referral to our service.”
Juliette Gentle, Director of Orthopaedic Surgery at Northern Health states “The key messages were optimising non-operative management of hip and knee arthritis in the community, promoting resources for GP’s and their patients and highlighting programs available for referral.”
“There is irrefutable research evidence (at least 44 randomised controlled trials) to support the assertion that structured, targeted exercise therapy improves pain management and function, regardless of the severity of radiographic findings or pain severity,” claims Tom Collins, Clinical Leader Physiotherapy – Advanced Practice at Northern Health.
“What patients are often not told, is that 10 percent of patients are unsatisfied with their knee replacement surgery outcomes at one year, and 20 percent have no clinically meaningful improvement in pain or function,” he adds.
Speakers included Anton Harms – Advanced Practice Musculoskeletal Physiotherapist, Akilan Velayudhan – Anaesthetic Consultant and Pain Specialist and Juliette Gentle.
Anton Harms says “Over my time at Northern Health, I have witnessed remarkable improvements in many patients’ osteoarthritis knee pain through specific exercise and weight control improvements, that I would not have thought possible if I had not witnessed it.”
“The aim of the GP session was to try and convey this to them and in particular, to inform them about the GLA:D program for hip and knee osteoarthritis.”
The GLA:D program developed in Denmark, provides the minimally effective dosage of exercise for knee and hip arthritis. This consists of two one hour exercise sessions per week for six weeks.
A patient of the GLA:D program at DPV Community Health, Epping, Pamela Horton, can attest to the effectiveness of it. “I did not want to get surgery, so I was willing to try anything.”
“I think it was the best thing ever for me,” she continues.
“Because of the program, I’m actually walking really well and I’m not going for the operation.”
Anton says, “As the primary point of contact, the GP’s have a critical role in advocating for and arranging rehabilitation before considering referral to the Orthopaedic Department.”
“Pain and disability are a massive problem, in particular in our community. It just so happens that we have the perfect group of collaborative, passionate, skilled team members (Juliette, Anton, Briana, Wanda, Akilan and Jake from the pain team) to make this model of care work,” Tom says.
Featured image left to right: Anton Harms, Juliette Gentle and Karen Overall.
