Arthritis: The Disease, The Program

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Arthritis The Disease, The Program
Interventions

• Debbie Campbell MBA, CHES
• Arthritis Health Section Chief
• Department of Health Human Services - Division
  of Health
• and
• Appathurai Balamurugan MD, MPH Senior
  Epidemiologist,
• Department of Health Human Services - Division
  of Health Assistant Professor, Dept. of
  Epidemiology, UAMS College of Public Health

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The Arthritis Story

• 70 million Americans
• Leading cause of disability among Americans over
  age 15
• Affects nearly 300,000 children
• Baby boomers are now at prime risk, as more than
  half those affected are under age 65

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The Arthritis Story Cont.

• Second only to heart disease as a cause of work
  disability
• 39 million physician visits every year
• More than a half million hospitalizations per
  year
• 86.2 billion annually

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Outline

• Arthritis Economic Disease Burden
• Arthritis Health Program
• Arthritis Management

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Arthritis is an umbrella term
Rheumatoid Arthritis
Juvenile Arthritis
Fibromyalgia
Osteoarthritis
Ankylosing Spondylitis
Lyme Disease
Lupus
Gout
Bursitis
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Source BRFSS, 2004
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Percentage of Population
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Figure 4. Percentage of Adults with Arthritis,
2003
People 18 or older with self-reported,
doctor-diagnosed arthritis. Source CDC,
Behavioral Risk Factor Surveillance System, 2003
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Figure 5. Arthritis Prevalence In Arkansas By Age
Categories, 2004
Percentage with Arthritis
Source BRFSS, 2004
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Figure 6. Arthritis Prevalence in Arkansas by
gender, 2004
Percentage with Arthritis
Source BRFSS, 2004
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Figure 7. Arthritis Prevalence in Arkansas by
race, 2004
Percentage with Arthritis
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Arthritis Prevalence in Arkansas, 2002
Prevalence of Doctor- Diagnosed Arthritis ?
24.6 29.9 30.0 34.9 35.0 39.9
40.0 48.6 BRFSS 2002
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Cost Due to Arthritis and Related Conditions
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Figure 8. Total Cost Attributable to Arthritis
and Other Rheumatic Conditions, Using Selected
Categories, 50 States and D.C., U.S., 1997
2.2 8.4 billion
750 million - 1.3 billion
1.5 - 2.2 billion
121 million - 578 million
Total direct (costs attributable to medical
expenditures) indirect (costs attributable to
work loss) Source CDC Arthritis Program
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Direct Healthcare Expenses Due to Arthritis

• Site of Service Costs
  Rank
• Home Healthcare 2.49 B
  1
• Ambulatory care 7.93 B
  2
• In-patient 5.70 B
  4
• Prescription Meds 5.15 B
  5

Source Healthcare Spending and Use Among United
State Community-Dwelling Adults for the 20 most
costly conditions
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Direct Healthcare Expenses Due to Arthritis by
Source of Payment
Billions of dollars
Source Healthcare Spending and Use Among United
State Community-Dwelling Adults for the 20 most
costly conditions
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Number of Hospital Discharges
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Millions of Dollars ()
Year
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Thousands of Dollars
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Osteoarthritis (OA)

• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment

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Number of Hospital Discharges
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Millions of Dollars ()
Year
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Rheumatoid Arthritis (RA)

• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment

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Number of Hospital Discharges
Year
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Millions of Dollars ()
Year
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Systemic Lupus Erythematosus (SLE)

• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment

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Number of Hospital Discharges
Year
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Millions of Dollars ()
Year
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Gout

• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment

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Number of Hospital Discharges
Year
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Millions of Dollars ()
Year
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Fibromyalgia

• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment

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Back Pain

• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment

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Infectious Arthritis

• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment

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Occupational Sports Related Injuries Causing
Arthritis

• Clinical presentation
• Occupational CTS
• Sports Tennis Elbow
• Epidemiology
• Diagnosis
• Treatment

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Juvenile Arthritis

• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment

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Health Status Among People With Arthritis
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Arthritis is the No. 1 cause of disability in the
US and in AR
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Figure 21. Health status among people with
arthritis
Source BRFSS, 2004
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Percentage
Source BRFSS, 2004
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Risk FactorsPreventive Care Services
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Figure 23. Role of Body weight in Arthritis
Source BRFSS, 2004
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Figure 24. Role of Physical Activity in Arthritis
Source BRFSS, 2003
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Source BRFSS, 2004
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• ARthritis
• Health Program

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Mission

• Reduce the Impact of Arthritis and other
  Rheumatic Conditions among Arkansans

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Goals

• Increase Awareness and Knowledge
• Expand Evidence-based Interventions
• Establish and Maintain Partnerships
• Expand and Maintain Surveillance

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Interventions(No Longer Sitting Still for the
Pain)

• Health Communication Campaign
• Evidence-Based Programs

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Physical Activity. The Arthritis Pain Reliever
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Physical Activity and Arthritis
Pain Relief
Improved Joint Function
Weight Loss
Physical Activity
Improved Well-being
Reduced Disability
Overall Health Benefits
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Benefits of Exercising With Arthritis

• Joint flexibility mobility
• Nourishes cartilage
• Muscle strength
• Cardiovascular fitness, circulation
• Weight control, better appearance
• Sense of well-being, less stress depression

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Benefits of Exercising With Arthritis Cont.

• Bone strength
• Endurance, stamina, more energy
• Function, ability to perform daily activities
• Posture, balance coordination
• Regular bowel habits
• Quality of sleep

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1. Arthritis Foundation Aquatic Program
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Aquatics Classes In Arkansas Counties
Aquatics classes Source Arthritis Foundation,
6/8/2005
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2. Arthritis Foundation Exercise Program
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PACE Classes In Arkansas Counties
_at_ PACE classes Source Arthritis Foundation,
6/8/2005
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3. Arthritis Foundation SelfHelp ProgramTake
Control With Knowledge
ASHC WORKSHOP OVERVIEW
TOPICS Week One Week Two Week Three Week Four Week Five Week Six
1. Self-Management Principles v
2. Pain-Management Principles v
3. Cognitive Pain Management v v v v
4. Goal-Setting/Action Plans v v v v v v
5. Problem-Solving Steps v
6. Exercise/Fitness v v v
7. Feedback/Problem-Solving v v v v v
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3. Arthritis Foundation SelfHelp ProgramTake
Control With Knowledge
ASHC WORKSHOP OVERVIEW
TOPICS Week One Week Two Week Three Week Four Week Five Week Six
8. Difficult Emotions v
9. Healthy Eating v
10. Osteoporosis v
11. Fatigue and Energy Conservation v
12. Medication Usage v
13. Depression v
14. Working with Health Care Providers v
15. Evaluating Treatments v
16. Sleep v
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Support Groups

• Arthritis Support Group
• Lupus Support Group
• Fibromyalgia Support Group

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Support Groups In Arkansas Counties
Arthritis support group Fibromyalgia support
group _at_ Lupus support group Source Arthritis
Foundation, 6/8/2005
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• Arthritis Management

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10 Signs Of An Unproven Arthritis Remedy

• 10. The "Conspiracy Theory"
• 9. It's a "Special Diet "
• 8. It's "Untested
• 7. Drugs and Surgery are
• "Condemned"
• 6. The Body is "Cleansed"

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10 Signs Of An Unproven Arthritis Remedy Cont.

• 5. It's "Quick or Simple"
• 4. Advertising is "Sensationalized"
• 3. The "Testimonial"
• 2. It's a "Secret"
• 1. It's a "Cure"

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Arthritis Treatment

• Medical management Analgesics, NSAIDs, DMARDs,
  Biologic response modifiers, Corticosteriod
• Surgery Traction, Joint or Disc replacement,
  Laser, endoscopy

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Alternative Treatment for Arthritis
Hot Springs, Arkansas
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Alternative Treatment for Arthritis Cont.

• Green tea
• Homeopathy
• Hydrotherapy
• Massage
• Meditation
• Tai Chi
• Yoga

• Acupuncture
• Ayurveda
• Biofeedback
• Chiropractic
• Chondroitin sulfate
• Copper bracelet
• Chinese Herbs
• Diet Supplements
• Fish oil

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Recent Advances in Arthritis Management

• Newer Drugs abatacept, Rituximab, Febuxostat
• Medicare Part D prescription drug plan
• Research findings Weight loss and Exercise
• FDA decision on COX-2 selective inhibitor drugs
• Genetic research

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CDC Recommendations

• See Your Doctor
• Learn What You Can Do
• Be Active
• Watch Your Weight
• Protect Your Joints