Efectividad de un modelo de tratamiento integral de la osteoartrosis

Abstract

Introduction. Osteoarthrosis (OA) is the most frequent degenerative joint disease causing a significant social burden and being a frequent cause of disability. It also affects the mental health of patients and increases health care costs, including costs of hospitalization or admission to emergency services. The most deteriorated joints are the knees, hands, hips, and spine; above all among female patients. Obesity is the main risk factor. Despite the international recommendations, comprehensive patient management is rare and most therapeutic interventions are isolated and focused on the administration of non-steroidal anti-inflammatory drugs (NSAID), viscosupplementation, or intra-articular administration of corticosteroids. Objective. The objective of this non-comparative retrospective study was to test the effectiveness of a comprehensive medical treatment (CMT) model for OA that has been implenting in Mexico since 2006. Material and Methods. To determine the OA improvement in the patient receiving a CMT scheme that includes phytopharmaceuticals, rehabilitation, nutritional intervention, patient education, and a telephone attention program, the consumption of traditional medicines (NSAID) was compared before and after the intervention and clinimetrically measuring the visual analog evaluation, number of painful joints, number of swollen joints, evaluation global assessment of the disease by the patient, global assessment of the disease by the treating physician, muscle strength, Health Assessment Questionnaire, and adherence to treatment. Results. Approximately 18% (17.92%) of the patients in the sample were taking two or more medications at the beginning of the study; at the end, only 2.79% took them. The proportion of patients with no drug, monotherapy and combination of drugs and/or supplements is significant between the initial visit and the final visit. In the clinimetric domain, a statistically significant decrease (p> 0.01) was found between the value of the initial visit and the final visit. The number of painful joints and swollen joints from the initial visit to the final visit decreased statistically significantly. The global assessment of the disease by the patient from the initial visit to the final visit decreased statistically significantly. Discussion. CMT with periodic monitoring, phytopharmaceutical patient education, nutritional intervention, rehabilitation, and a telephone service program is effective for the control of osteoarthritis.