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Chronic Osteoarthritis Management Initiative (COAMI) Promotes New Approach to Common Form of Arthritis

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Osteoarthritis (OA) is the most common form of arthritis, affecting 27 million Americans or over 10 percent of adults.  Many factors - some more modifiable than others - contribute to an increased risk of developing OA, including obesity, genetics, aging, and the consequences of joint injuries and trauma (for example, from sports injuries or job-related injuries). 

As OA progresses, it can cause enough pain and disability that it interferes with work and daily activities, including the ability to be physically active.  Lack of regular physical activity can lead to even more health consequences, since many people with OA also have been diagnosed with other chronic conditions, such as diabetes, whose treatment and management often require greater levels of physical activity and weight loss.

Even though OA could be viewed as a chronic condition, it's not usually approached that way.  For example, the standard for other chronic conditions (such as diabetes or heart disease) now involves screening for risk factors, prevention-oriented interventions, ongoing monitoring, and comprehensive care models.  Instead of this emphasis on early intervention and prevention, OA interventions tend to start later in the disease process. Many patients and health care providers tolerate and expect joint pain as an anticipated consequence of aging, and joint replacement as an inevitable endpoint of OA. 

Paying attention to patients' symptoms (starting with asking about them in various settings), following up both proactively and longitudinally, and applying the principles of integrated, multi-specialty systems of care all would improve outcomes for the millions of people with OA. Moreover, many of these changes could be implemented now.

To help change and improve the current approach to managing OA, the Chronic Osteoarthritis Management Initiative (COAMI) Work Group was convened by the U.S. Bone and Joint Initiative in May 2012 in Chicago, a result of the which a Call to Action was issued.

In September 2013 the working group was expanded and the Osteoarthritis Management Conference held to start the development of a model of care.

If you have questions about COAMI, please email the U.S. Bone and Joint Initiative at usbji@usbji.org.