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Osteoarthritis patients 'lost'

Patients with osteoarthritis are being left to deteriorate on waiting lists without proper treatment because of communication breakdowns, an NHS study warns.

Management of pain was 'inadequate, with few referrals to appropriate services', the researchers concluded. They suggested patients were falling through the gap between primary and secondary care because of poor communication between them, writes Gareth Iacobucci.

Patients' quality of life fell over time, with significant declines in physical function and bodily pain after three months on waiting lists. Some 63 per cent experienced constant pain throughout their time waiting for surgery.

Study leader Dr Gretl McHugh, research fellow at the school of nursing, midwifery and social Work, University of Manchester, said there was 'very poor information provision both on pain and how to manage osteoarthritis'.

Dr McHugh said: 'Pain is difficult to manage with this group of patients and there needs to be more proactive management by health professionals, and better co-ordination between primary and secondary care about who is managing these individuals on the waiting list.'

She added that 'better pain management in terms of a review of patients' medication, or even just an assessment of pain they're experiencing', could improve the situation.

The study, published on the NHS research findings register last week, surveyed 105 patients aged 40 to 86 awaiting surgery over a nine-month period.

It concluded: 'The high levels of pain, poor physical functioning and reduced quality of life in adults with osteoarthritis are of concern.'

Dr Graham Archard, vice-chair of the RCGP and a GP in Christchurch, Dorset, agreed there needed to be better dialogue between primary and secondary care, and that there was still 'a long way to go' on reducing waiting lists. He said there was an 'extreme necessity' for GPs to have access to appropriate pain management guidelines, and warned current guidelines 'are not GP friendly'.

He added: 'Because there's no national NICE guidance on pain management, it has been left to the pharmaceutical industry to provide information.'

• For the latest pain management evidence, go to searchmedica.co.uk

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