Interprofessional Osteoarthritis Care: A Pilot for Interprofessional Care and Education

Abstract

Background: An osteoarthritis (OA) pilot was initiated in an interprofessional clinic to provide a learning opportunity for practitioners to provide integrated care in the setting of OA to improve health outcomes and quality of life in patients living with osteoarthritis. This study was a qualitative analysis performed following the completion of the pilot. Purpose: To determine effective processes that support integrated care to best serve those living with osteoarthritis. Methods: Flyers and neighborhood mailers were provided to the community to inform patients of the OA pilot. Patients were screened by the nurse practitioner and physical therapists to ensure they met osteoarthritis criteria (> 45 years, were experiencing activity-related joint pain, and had no morning joint-related stiffness, or > 30 minutes of morning stiffness). The interventions included one integrated care visit (in-person) followed by telehealth care thereafter. Telehealth visits obtained patient feedback, provided further patient guidance based on patient-response to care plans, and to evaluate change in function, medication usage, and pain management from baseline. The following questions aided researchers to organize our findings following the 3-month pilot: (1) What methods were utilized to aid in patient function and mobility improvement? (2) What was done to ensure safe and effective medication use? (3) How best to utilize each practitioner so that (a) methods for pilot duplication were determined and (b) integrated care best practices were established? Results: Function and mobility improvement were exhibited in 100% of the patients. Mental health services were utilized to overcome fear of movement and fear of pain barriers to mobility. Half of the patients were originally performing movement exercises that were harmful to their condition prior to obtaining a consult with the physical therapist. The pharmacist-driven medication review during the initial consult identified 88% of the patients were utilizing suboptimal medications for the management of their OA, and 25% were using unsafe dietary supplements. All unsafe medication and dietary-supplement usage was resolved. Establishing care with a team visit supported integrated healthcare engagement. Telehealth and incorporation of healthcare students for follow-up calls were effective for utilization of all practitioners, patient engagement, and supported improved patient outcomes. Conclusion: The findings of this study outline best practices that support integrated care, integrated education, and improved patient outcomes.