[et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” background_color=”#c7c89b” custom_margin=”||||false|false” custom_padding=”||20px||false|false” global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ _module_preset=”default” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text module_class=”heading” _builder_version=”4.16″ _module_preset=”default” text_font=”Source Sans Pro|600||on|||||” text_text_color=”#000000″ text_font_size=”40px” text_line_height=”1em” header_text_align=”left” header_2_font=”Source Sans Pro|600|||||||” header_2_text_align=”center” header_2_text_color=”#ffc212″ header_2_line_height=”1.4em” custom_margin=”||||false|false” custom_padding=”||||false|false” text_line_height_tablet=”” text_line_height_phone=”1em” text_line_height_last_edited=”on|phone” header_2_text_shadow_style=”preset1″ global_colors_info=”{}”]Development of a Comprehensive Care Plan[\/et_pb_text][et_pb_text _builder_version=”4.17.4″ _module_preset=”default” text_font=”Source Sans Pro|600||on|||||” text_text_color=”#000000″ text_font_size=”22px” text_line_height=”1em” header_text_align=”left” header_text_color=”#FFFFFF” header_font_size=”38px” header_2_font=”Source Sans Pro|600|||||||” header_2_text_align=”center” header_2_text_color=”#ffc212″ header_2_line_height=”1.4em” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” header_2_text_shadow_style=”preset1″ global_colors_info=”{}”]<\/p>\n
STANDARD 2<\/p>\n
[\/et_pb_text][et_pb_text _builder_version=”4.16″ _module_preset=”default” text_font=”||||||||” text_text_color=”#000000″ text_font_size=”20px” text_line_height=”1.5em” custom_padding=”||20px||false|false” global_colors_info=”{}”]A care plan is developed in collaboration with the person living with osteoarthritis of the hip or knee through discussion of evidence-informed treatment options. Using a shared decision-making approach will ensure the individual\u2019s health priorities, goals, values and preferences provide a foundation for the care plan.[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ fullwidth=”on” disabled_on=”on|off|off” _builder_version=”4.16″ _module_preset=”default” background_color=”#c7c89b” background_enable_image=”off” background_size=”contain” background_position=”center_left” custom_margin=”-12px||||false|false” custom_margin_tablet=”-12px||||false|false” custom_margin_phone=”0px||||false|false” custom_margin_last_edited=”on|phone” custom_padding=”||33px||false|false” global_colors_info=”{}”][et_pb_fullwidth_image src=”https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/line-1.png” title_text=”line (1)” _builder_version=”4.16″ _module_preset=”default” width=”80%” max_width=”80%” global_colors_info=”{}”][\/et_pb_fullwidth_image][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” custom_margin=”0px||0px||true|false” custom_padding=”0px||0px||true|false” top_divider_color=”rgba(12,113,195,0.32)” top_divider_height=”27px” global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][lwp_divi_breadcrumbs _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][\/lwp_divi_breadcrumbs][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ custom_padding_last_edited=”on|phone” _builder_version=”4.16″ _module_preset=”default” background_color=”#FFFFFF” custom_padding=”0px||||false|false” custom_padding_tablet=”” custom_padding_phone=”0px||0px||true|false” global_colors_info=”{}”][et_pb_row _builder_version=”4.17.4″ _module_preset=”default” custom_padding=”||0px||false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text module_class=”heading” _builder_version=”4.17.4″ _module_preset=”default” text_font=”|600||on|||||” text_text_color=”#000000″ text_font_size=”40px” header_text_color=”#000000″ header_2_font=”Source Sans Pro|600|||||||” header_2_text_align=”center” header_2_text_color=”#ffc212″ header_2_line_height=”1.4em” custom_padding=”||||false|false” header_2_text_shadow_style=”preset1″ global_colors_info=”{}”]<\/p>\n
OVERVIEW<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.17.4″ _module_preset=”default” text_font_size=”18px” global_colors_info=”{}”]<\/p>\n
Key Messages for Development of a Care Plan<\/strong><\/p>\n [\/et_pb_text][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.18.0″ _module_preset=”default” text_text_color=”#000000″ text_font_size=”18px” background_color=”#f2f2f2″ custom_padding=”20px|20px|20px|20px|true|true” border_radii=”on|20px|20px|20px|20px” global_colors_info=”{}”]<\/p>\n View All Resources<\/strong><\/a><\/p>\n View References<\/strong><\/a>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ module_class=”desk” _builder_version=”4.16″ _module_preset=”default” background_color=”rgba(255,255,255,0.86)” background_image=”https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/Pngtree\u2014blue-hexagon-abstract-medical-technology_1298247-e1653654071890.jpg” background_size=”initial” background_position=”top_left” background_blend=”overlay” custom_margin=”||||false|true” custom_padding=”||100px||false|true” global_colors_info=”{}”][et_pb_row column_structure=”1_4,3_4″ _builder_version=”4.18.0″ _module_preset=”d55fc8c6-b5de-4b77-a65b-80d125d2b382″ global_colors_info=”{}”][et_pb_column type=”1_4″ _builder_version=”4.18.0″ _module_preset=”e067a3d0-44a1-4396-9c39-e633c5db2c25″ background_color=”rgba(255,255,255,0.64)” z_index=”1″ global_colors_info=”{}”][et_pb_text _builder_version=”4.18.0″ _module_preset=”46786535-2f5d-4ee1-8e00-c908da837293″ custom_margin=”||0px||false|false” global_colors_info=”{}”]<\/p>\n Introduction<\/a><\/p>\n [\/et_pb_text][et_pb_text _builder_version=”4.18.0″ _module_preset=”46786535-2f5d-4ee1-8e00-c908da837293″ global_colors_info=”{}”]Building a care plan<\/a>[\/et_pb_text][et_pb_text _builder_version=”4.18.0″ _module_preset=”46786535-2f5d-4ee1-8e00-c908da837293″ global_colors_info=”{}”]Putting a care plan into action<\/a>[\/et_pb_text][et_pb_text _builder_version=”4.18.0″ _module_preset=”46786535-2f5d-4ee1-8e00-c908da837293″ global_colors_info=”{}”]SMART goals<\/a>[\/et_pb_text][et_pb_text _builder_version=”4.18.0″ _module_preset=”46786535-2f5d-4ee1-8e00-c908da837293″ global_colors_info=”{}”]Conservative OA toolbox<\/a>[\/et_pb_text][\/et_pb_column][et_pb_column type=”3_4″ _builder_version=”4.16″ _module_preset=”default” custom_padding=”||||false|false” global_colors_info=”{}”][et_pb_text _builder_version=”4.18.0″ _module_preset=”default” text_font_size=”18px” global_colors_info=”{}”]<\/p>\n A care plan is a living document that describes the treatments discussed with the individual with OA and chosen to address their health concerns and goals. Each care plan is tailored to the individual and should account for their socio-economic status.<\/p>\n The conservative osteoarthritis (OA) care plan describes the treatments discussed with the individual and chosen to address a range of items. A care plan is a living document: it will evolve over time. Standard 3<\/a> describes how to tailor care over time after the initial care plan is created.<\/p>\n A care plan is developed considering the person\u2019s:<\/span><\/p>\n While keeping all the items described above in mind, an OA care plan will be built by:<\/span><\/p>\n [\/et_pb_text][et_pb_divider color=”#000000″ _builder_version=”4.16″ _module_preset=”default” custom_margin=”20px||||false|false” custom_padding=”20px||||false|false” global_colors_info=”{}”][\/et_pb_divider][et_pb_text module_id=”building” _builder_version=”4.18.0″ _module_preset=”default” text_font_size=”18px” global_colors_info=”{}”]<\/p>\n Each individual seeks care at different points in their disease activity, their symptomology, and with varying levels of knowledge about OA.<\/p>\n The Conservative OA Treatments are provided below. They are structured to:<\/p>\n Core Treatments can be tailored to the individual\u2019s needs and preferences. They include:<\/b><\/p>\n Adjunct Treatments can also be tailored to the individual\u2019s needs and preferences.<\/b> They are used to support the trials of and achievement of Core Treatments. See Standard 7<\/a> for more information.<\/p>\n These tables<\/a> provide examples of specific treatments in every treatment category to assist the clinician with the building of a care plan. More detail is available for clinician guidance on stepping through the conservative OA treatments toolbox<\/a>. Shared decision-making<\/a> techniques are evidence-based and promote satisfaction and success with the care plan.<\/p>\n The OA Self Management Toolkit<\/a> is for individuals with OA. This document is an education booklet with introductory information about OA, and three tools for the individual: a Report Card<\/a>, a Treatment Menu<\/a> and an example Resource Inventory<\/a>. These tools can support and empower the individual in choosing their own preferred treatment options and can promote self-management<\/a> of conservative OA management in the long term.<\/p>\n It is important to keep in mind that each individual with OA seeks care at different points in their OA journey. Chronic disease management can be overwhelming to individuals with OA, particularly when individuals try to change too much at one time. For individuals that are ready, encourage them to start with setting one to two goals that are important to them, and breaking them down into smaller steps. Ultimately, the complexity of the care plan should be proportional to the individual\u2019s experience and enthusiasm, while remaining realistic.<\/p>\n<\/div>\n [\/et_pb_text][et_pb_divider color=”#000000″ _builder_version=”4.16″ _module_preset=”default” custom_padding=”20px||||false|false” global_colors_info=”{}”][\/et_pb_divider][et_pb_text _builder_version=”4.16″ _module_preset=”default” text_font_size=”18px” global_colors_info=”{}”]<\/p>\n As soon as feasible after an OA diagnosis, the individual with OA will have:<\/p>\n An example of how a multi-disciplinary team may be used to achieve an actioned care plan quickly is provided<\/a>.<\/p>\n The exception to this is if the individual is a candidate for immediate referral to an orthopaedic surgeon (Standard 1<\/a>). In which case a conservative treatment plan should still be created but in complement with the surgeon\u2019s orders. Standard 8<\/a> talks more about how surgery may only be one step in the ongoing journey of conservative management of OA.<\/p>\n<\/div>\n [\/et_pb_text][et_pb_divider color=”#000000″ _builder_version=”4.16″ _module_preset=”default” custom_padding=”20px||||false|false” global_colors_info=”{}”][\/et_pb_divider][et_pb_text _builder_version=”4.17.4″ _module_preset=”default” text_font_size=”18px” global_colors_info=”{}”]<\/p>\n SMART goals are a tool of shared decision-making<\/a> and are becoming more common in healthcare. The use of SMART goals can promote adherence to the non-surgical<\/span><\/span> osteoarthritis (OA) management Care Plan by meeting the individual where they are at in their readiness to change. Meet the individual where they are at by tailoring the scope of the goal appropriately. This also helps both the individual and the clinician attach accountability to the changes. SMART goals are:<\/p>\n <\/p>\n SMART goals take practice to write and are most successful when they are created in collaboration between a clinician and an individual with OA (shared decision-making). For some clinicians the skills required for the collaborative care described in these standards may be new territory. The following are suggestions for additional training that clinicians may find beneficial:<\/p>\n [\/et_pb_text][et_pb_divider color=”#000000″ _builder_version=”4.16″ _module_preset=”default” custom_padding=”20px||||false|false” global_colors_info=”{}”][\/et_pb_divider][et_pb_text _builder_version=”4.18.0″ _module_preset=”default” text_font_size=”18px” global_colors_info=”{}”]<\/p>\n To start the development of a care plan: understand the health priorities, goals, values, preferences, overall wellbeing<\/a> and experiences with conservative treatments of your individual with osteoarthritis (OA) of the hip or knee. Use shared decision-making<\/a> techniques with your individual to identify the most important problem to address and this will help guide the initial care recommendations you make.<\/p>\n Each individual seeks care at different points in their disease activity, their symptomology, and with varying levels of knowledge about OA. The Conservative OA Treatments should be tailored to the individual\u2019s needs:<\/p>\n For all individuals with OA, effective management requires trial and error with the evidence-based conservative treatments. Not all treatments will work for all individuals. Some treatments may work for a short period of time and then not again. Some treatments can be returned to after a long break and may be more successful when the individual\u2019s goals, preferences or symptoms have changed.<\/p>\n The Conservative OA Treatments allow the clinician to use their expertise to combine any number of treatments to ultimately support:<\/p>\n The following are instructions for how to use the Conservative OA Treatments to build a care plan. Also use these tables for specific examples of each sub-category of treatments.<\/p>\n While the Conservative OA Treatments are a tool for clinicians, clinicians should not use it in isolation without collaborating with the individual. Shared decision-making techniques<\/a> can be used to build the individual\u2019s care plan. The Treatment Menu and the Resource Inventory from the OA Self Management Toolkit are the individual-facing tools that align with the Conservative OA Treatments.<\/p>\n Note: if the individual with OA presents with symptoms that require immediate referral to surgery (see Standard 1<\/a>), then the building of a care plan should be structured to complement the orthopaedic surgeon\u2019s orders, whether the individual is a surgical candidate or not. See Standard 8 for more details: the conservative OA management journey does not end with surgery. <\/strong><\/p>\n<\/div>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ module_class=”mob” _builder_version=”4.17.4″ _module_preset=”default” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ _module_preset=”default” global_colors_info=”{}”][et_pb_accordion _builder_version=”4.18.0″ _module_preset=”7edfcb3f-f900-45e5-aca9-ee6492dc7b76″ global_colors_info=”{}”][et_pb_accordion_item open=”on” _builder_version=”4.16″ _module_preset=”default” custom_css_main_element=”display:none;” global_colors_info=”{}”][\/et_pb_accordion_item][et_pb_accordion_item title=”INTRODUCTION” _builder_version=”4.18.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]A care plan is a living document that describes the treatments discussed with the individual with OA and chosen to address their health concerns and goals. Each care plan is tailored to the individual and should account for their socio-economic status.<\/p>\n The conservative osteoarthritis (OA) care plan describes the treatments discussed with the individual and chosen to address a range of items. A care plan is a living document: it will evolve over time. Standard 3<\/a> describes how to tailor care over time after the initial care plan is created.<\/p>\n A care plan is developed considering the person\u2019s:<\/span><\/p>\n While keeping all the items described above in mind, an OA care plan will be built by:<\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”BUILDING A CARE PLAN” _builder_version=”4.18.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]Each individual seeks care at different points in their disease activity, their symptomology, and with varying levels of knowledge about OA.<\/p>\n The Conservative OA Treatments are provided below. They are structured to:<\/p>\n Core Treatments can be tailored to the individual\u2019s needs and preferences. They include:<\/b><\/p>\n Adjunct Treatments can also be tailored to the individual\u2019s needs and preferences.<\/b> They are used to support the trials of and achievement of Core Treatments. See Standard 7<\/a> for more information.<\/p>\n These tables<\/a> provide examples of specific treatments in every treatment category to assist the clinician with the building of a care plan. More detail is available for clinician guidance on stepping through the conservative OA treatments toolbox<\/a>. Shared decision-making<\/a> techniques are evidence-based and promote satisfaction and success with the care plan.<\/p>\n The OA Self Management Toolkit<\/a> is for individuals with OA. This document is an education booklet with introductory information about OA, and three tools for the individual: a Report Card<\/a>, a Treatment Menu<\/a> and an example Resource Inventory<\/a>. These tools can support and empower the individual in choosing their own preferred treatment options and can promote self-management<\/a> of conservative OA management in the long term.<\/p>\n It is important to keep in mind that each individual with OA seeks care at different points in their OA journey. Chronic disease management can be overwhelming to individuals with OA, particularly when individuals try to change too much at one time. For individuals that are ready, encourage them to start with setting one to two goals that are important to them, and breaking them down into smaller steps. Ultimately, the complexity of the care plan should be proportional to the individual\u2019s experience and enthusiasm, while remaining realistic.[\/et_pb_accordion_item][et_pb_accordion_item title=”PUTTING A CARE PLAN INTO ACTION” _builder_version=”4.18.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]<\/p>\n As soon as feasible after an OA diagnosis, the individual with OA will have:<\/p>\n An example of how a multi-disciplinary team may be used to achieve an actioned care plan quickly is provided<\/a>.<\/p>\n The exception to this is if the individual is a candidate for immediate referral to an orthopaedic surgeon (Standard 1<\/a>). In which case a conservative treatment plan should still be created but in complement with the surgeon\u2019s orders. Standard 8<\/a> talks more about how surgery may only be one step in the ongoing journey of conservative management of OA.<\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”SMART GOALS” _builder_version=”4.18.0″ _module_preset=”default” global_colors_info=”{}” open=”off”]<\/p>\n\n
KEY RESOURCES<\/strong><\/span><\/span><\/h3>\n
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\n<\/span><\/li>\n<\/ul>\nINTRODUCTION<\/h1>\n
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Building a Care Plan<\/h1>\n
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\n2<\/sup>Gay C, Chabaud A, Guilley E, Coudeyre E. Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. Annals of Physical and Rehabilitation Medicine. 2016;59(3):174-83.
\n3<\/sup>Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best evidence rehabilitation for chronic pain part 5: Osteoarthritis. Journal of Clinical Medicine. 2019;8(11):1769.
\n4<\/sup>Wellsandt E, Golightly Y.\u202fExercise in the management of knee and hip osteoarthritis. Current Opinion in Rheumatology. 2018;30(2):151-9.<\/span><\/span> which have the strongest evidence for conservative OA management; and<\/li>\n\n
\n3<\/sup>Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best evidence rehabilitation for chronic pain part 5: Osteoarthritis. Journal of Clinical Medicine. 2019;8(11):1769. <\/span><\/span> to encourage the individual to foster movement to influence joint health and achieve their activities of daily life \u2013 See Standard 5<\/a>.<\/li>\n
\n3<\/sup>Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best evidence rehabilitation for chronic pain part 5: Osteoarthritis. Journal of Clinical Medicine. 2019;8(11):1769. <\/span><\/span> to support the individual to prevent increased joint loading to influence joint health and achieve movement for their activities of daily life \u2013 See Standard 6<\/a>.<\/li>\n<\/ol>\nPUTTING A CARE PLAN INTO ACTION<\/h1>\n
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SMART GOALS<\/h1>\n
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CONSERVATIVE OA TOOLBOX<\/h1>\n
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\n2<\/sup>Gay C, Chabaud A, Guilley E, Coudeyre E. Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. Annals of Physical and Rehabilitation Medicine. 2016;59(3):174-83.
\n3<\/sup>Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best evidence rehabilitation for chronic pain part 5: Osteoarthritis. Journal of Clinical Medicine. 2019;8(11):1769.
\n4<\/sup>Wellsandt E, Golightly Y.\u202fExercise in the management of knee and hip osteoarthritis. Current Opinion in Rheumatology. 2018;30(2):151-9.<\/span><\/span> which have the strongest evidence for conservative OA management; and<\/li>\n\n
\n3<\/sup>Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best evidence rehabilitation for chronic pain part 5: Osteoarthritis. Journal of Clinical Medicine. 2019;8(11):1769. <\/span><\/span> to encourage the individual to foster movement to influence joint health and achieve their activities of daily life \u2013 See Standard 5<\/a>.<\/li>\n
\n3<\/sup>Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best evidence rehabilitation for chronic pain part 5: Osteoarthritis. Journal of Clinical Medicine. 2019;8(11):1769. <\/span><\/span> to support the individual to prevent increased joint loading to influence joint health and achieve movement for their activities of daily life \u2013 See Standard 6<\/a>.<\/li>\n<\/ol>\n\n