Osteoarthritis Case Study Analysis: OA 2, Health Management

This essay presents a detailed case study analysis of osteoarthritis (OA 2), focusing on an 81-year-old retired Italian immigrant, Mr. Jack Di Lorenzo. The report explores the etiology, prevalence, and impact of osteoarthritis, including its symptoms and contributing factors, particularly within the Australian context. The analysis delves into medication management, addressing polypharmacy issues and potential interactions of prescribed drugs like fish oil, willow bark, and glucosamine. Furthermore, the assessment and services available to individuals with OA, such as Myagedcare and Arthritis Australia, are examined, along with the importance of effective communication and self-management strategies. The essay highlights the significance of support systems, including family involvement and peer groups, to improve the quality of life for individuals affected by osteoarthritis.

Running Head: OA 0
Osteoarthritis
[Document subtitle]
FEBRUARY 12, 2020

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Table of Contents
Introduction...........................................................................................................................................2
Health issue.......................................................................................................................................2
Etiology..........................................................................................................................................2
Prevalence and impacts.................................................................................................................3
Symptoms and contributing factors..............................................................................................3
Medication management..................................................................................................................4
Fish oil............................................................................................................................................4
Willow bark....................................................................................................................................4
Glucosamine..................................................................................................................................4
Polypharmacy issues..........................................................................................................................5
Assessment and services...................................................................................................................5
Communication.................................................................................................................................6
Conclusion.............................................................................................................................................7
References.............................................................................................................................................9

OA 2
Introduction
Osteoarthritis is a type of arthritis that characterizes the breakdown and ultimate loss
of the cartilage on single or more joints. Cartilage is the protein substance that serves as the
cushion between the human bones of the joints. This particular health issue takes place more
commonly as people age and occurs more commonly in males after the age of 45. Females
aged 55 or above experience this health issues more frequently (Glyn-Jones et., 2015).
Osteoarthritis can be occurred in patient’s hands, hips, and knee. It is more common among
senior individuals compared to the younger individuals. Osteoarthritis is also known as
degenerative joint disease, degenerative type of arthritis, can wear and tear type of arthritis.
This particular health issue is caused by the damage to patient’s joints. This damage can
further accumulate as people age, which is why age is the main factor of the joint damage
resulting in osteoarthritis (Bijlsma, Berenbaum & Lafeber, 2011). This report will discuss
about the aetiology, occurrence and effects of this health issue in Australia, common
symptoms, and contributing factor. The medication management, assessment needs to be
undertaken, and the information should be shared with the patients will also be included in
this report.
Health issue
Etiology
The is no specific cause of this health issues, and the particular etiology is unknown.
There are host of the biologic and mechanical aspects that culminate in the occurrence of
osteoarthritis. Age genetic predisposition, being female, and obesity are linked with the high
risk of OA. Articular congenital malformations or trauma to the patient’s joint also increase
the risk of OA development (Chojnacki et al., 2014). additionally, high bone density ad
reduced estrogen level, for example postmenopausal female, might be linked to the increased

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risk of osteoarthritis in knee and hand. All these factors result in a joint condition that is
susceptible to trauma and to the outer mechanical stressors that worsened through different
physical activities (Sandell, 2012).
Prevalence and impacts
It has been identified that one in eleven Australians diagnosed with OA, and nearly
2.2 million individuals had this health issues in 2017-18. One in ten individuals with OA
aged 45 and over 3 in five individuals who diagnosed with OA are women. it is the third
leading reason of life years lost because of disability. It can impact every aspect of life
(Australian Institute of Health and Welfare, 2019). Particularly in Australia OA accounted for
19 per cent of the overall burden of the disorder because of musculoskeletal issues in 2015.
OA accounts the Australian health system an approximately 3.5 billion, representing around
28 per cent of total disease expenditure on the musculoskeletal issues (Ackerman et al.,
2018).
Symptoms and contributing factors
Symptoms associated with osteoarthritis commonly develop slowly and deteriorate
over time. The patient feel pain which is occurred in affected joints that might hurt during or
after body movement. Stiffness of joint is most noticeable after sleep or rest. The patient may
also feel tender when he or she apply pressure to it. The patients might also not be capable to
move their joint by its full range of motion. Other symptoms are grating sensation, bone
spurs, and swelling of tissues around the joint. Jack experienced headaches, pain, shortness of
breathing, and fatigue (Sridhar et al., 2012).
Some of the contributing factors associated with osteoarthritis includes older age,
being overweight, joint injuries that remain untreated, repeated stress on the joint, deformities
associated with bines, and different metabolic disorder. Certain occupations that require such

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recurrent pressure can increase osteoarthritis. Occupation that includes in this category
include keeling or squatting for hours, lifting, climbing stairs, and walking. As discussed in
the case study Jack has been working on the floor with heavy equipment’s, ignored his pain
for longer time, and refused double knee replacement. This might be the reason his condition
deteriorated (Heidari, 2011).
Medication management
Jack has been prescribed with different drugs like metoprolol, and meloxicam. other
medicines also included in her treatment are glucosamine and fish oil tablets, and aspirin.
Fish oil
Fish oil might infrequently upsurge the risk of bleeding when given in the
combination with other medications that can similarly cause bleeding for example aspirin
(Hill et al., 2016). The patient might experience uncommon bleeding or bruising, or
experience other signs and symptoms of bleeding for example faintness; light-headedness;
red or black, tarry stools; they may also cough or vomit fresh or dried blood that appears like
coffee grounds; serious headache; and weakness. Patient taking fish oil tablets may
experience symptoms like belching, breathing issues, heartburn, nausea, diarrhoea, rash, and
nosebleeds, depression, and increased blood pressure (WebMed, 2019).
Willow bark
Contains chemicals similar to aspirin. Taking willow bark along with aspirin might
increase the effects and side effects of aspirin. Some of the side effects the patient may
experience include stomach upset, and issues to digestive system. The patient may also develop
issues like itching, rashes, and allergies (Shara & Stohs, 2015).

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Glucosamine
This particular medicine can exacerbate the risk of bleeding when taken with
medicines to stop blood clot, for example aspirin. Most of the individuals who take this drug
tolerates it well, however there is a probability that he or she may experience some adverse
effects. Some of the common side effects associated with this drug include nausea, vomiting,
diarrhoea, constipation or heartburn (Salazar et al., 2014).
Polypharmacy issues
Polypharmacy is the coexisting intake of multiple drugs by patient. It is most common
among older people affecting around 40 per cent of the older people living in their homes. As
Jack has been taking different drugs, there is possibility that he may experience
polypharmacy issues. Osteoarthritis is the increasingly prevalent disease with the incident
rate that increases with age. Unfortunately, most commonly prescribed drug for providing the
symptomatic relief cause develop significant Gi ulceration (Heuberger & Caudell, 2011). For
example, in case of Jack, use of aspirin may cause intestinal damage. Symptoms caused by
polypharmacy includes tiredness, sleepiness, reduced alertness, constipation, diarrhoea,
tremors, visual and auditory problems, anxiety, and dizziness.
Assessment and services
Myagedcare is the initiative of Australian government for older individuals with
osteoarthritis and supports for different health issues. Myagedcare help the individual to find
health professional and services for their health issues. Jack can follow the steps mentioned in
the myagedcare portal. First step is to learn about what type of services he needs, and what
services are available. In the second step he will get information about how he can apply for
assessment. In the third step he will find a provider, and in the last stage he will be able to get
different services like commonwealth home support programs, home care package,
residential respite, transition care, short term restorative care and aged care home. he can also

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get the information about different services like self management courses, community
programs, information and education seminars, support groups etc. for his osteoarthritis on
arthritis Australia (MyAgedCare, 2019).
Disability support for individuals with osteoarthritis aged 65 or above is provided by
the aged care system. Recent initiatives of Australian government in the area of disability
provide potential to the significantly enhance the inclusion, support and different
opportunities for people with OA. This comprises the rollouts of National disability insurance
scheme and the state and nation-wide initiatives under the national disability strategy. OA
associated disability get fair and proper support. Support for the carers, to assist them in the
managing their quality of life is similarly essential (Brand et al., 2014).
He also needs an assessment to be undertaken like ACAT. ACAT is Aged Care
Assessment Team which include medical, nursing, and allied health professionals to assess
the physical, mental, medical, restorative, cultural, and social requirements. In case of Jack
physician assessment is essential which will be done by a nurse. The team asks for patient
history, explain the procedure to the patient, and conduct the assessment process. As jack
developed both psychological and physical issues, this assessment will help in the treatment
process (Department of Social Services, 2015).
Arthritis Australia is the organisation founded in 1949 and is the main body in
Australia for individuals with arthritis in ACT, NSW, Northern territory, Queensland, South
Australia, and Tasmania (Arthritis Australia, 2017). There are number of peer support groups
helping individuals with OA such as Ararat Arthritis Support group, Ballarat Arthritis peer
support group, bendigo arthritis club inc, and online forum by beyond blue (Musculoskeletal
Australia, 2018).

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Communication
In case of Jack the healthcare provider must share complete information related to his
health issue, impact of the disease, bereavement, and retirement on his relatives and to self
management strategies at his home. Jack and his family should be provided with proper
information about issues like pain, problems in performing daily life works. Patient living
with OA often developed depression and stress. Therefore, Jack and his family should be
educated about managing such problems. Patient fall is one of the main risks associated with
the OA. In case of Jack there is ahigh risk of fall as he is old and unable to perform normal
activities like walking and climbing stairs. Therefore, the family members should be
informed to help the patient in managing daily activities. Bereavement and social isolation
often experienced by the OA patients which can further deteriorate the condition (Chou et al.,
2018). After the death of his wife there is a great probability that he experienced stress. After
the discharge from the hospital he will be recommended to self manage OA at his home. Jack
has been working for many years, now taking retirement on his family might develop social
isolation issues which hinder the treatment process. Therefore, the Jack and his family should
eb educated to engage him in social activities. Self management programs can be
implemented in case of Jack. Self-management teaching programmes are behavioural
interferences designed to inspire individuals with long-lasting disease to take a lively role in
the management process of their own disorder (Ganji et al., 2018). These particular
programmes aim to recover outcomes for diseased persons by supporting, not substituting,
medical care. The education content used to teach patients about their disorder and to clarify
how they can best accomplish their sign and symptoms differs between programmes. In the
self management programs Jack will be encouraged to follow some simple ways to ease his
OPA symptoms. He will be encouraged to east a balanced diet. As the patient is suffering
from multiple health issues, a balanced diet can play a vital role in managing his OA

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problem. research indicates that different nutrients like vitamin c, omega 3 fatty acids can
ease the OA symptoms. Jack and his family should be informed to discuss with the physician
before taking any medication out of prescription (Chapman et al., 2019).
Conclusion
Osteoarthritis is the form of arthritis features breakdown and loss of cartilage which is
the protein works as cushion between the bones and joint. There are different risk factors
associated with OA such as genetic predisposition, being female, old age, and obesity. It has
been identified that 1 in 11 Australian affected by this health issues and it accounts for 3.5
million expenditure on health care services for patients. Symptoms associated with OA
include pain, stiffness of joints, tenderness, bone spurs, swelling of tissues etc. the
contributing factors are old age, untreated joint injuries, and metabolic diseases. Taking
complimentary medication without consultation may also deteriorate the condition. In case of
Jack fish oil tablets and willow bark tea, and glucosamine can interact with aspirin and other
recommended drugs. Polypharmacy issues may cause tiredness, reduced alertness,
constipation, etc. Appropriate groups like Myagedcare can help Jack to get assessment
services. The national disability insurance scheme supports individual’s with osteoarthritis by
providing them health care insurance. Aged care Assessment team can be assigned to assess
the patient for physical mental and social aspects. Arthritis Australia is the supportive agency
working for people with OA. To help the patient to take care of this health issue at home, he
must be informed about the balanced diet, avoiding fall, stress reduction strategies, and take
part in self management programs.

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References
Ackerman, I. N., Pratt, C., Gorelik, A., & Liew, D. (2018). Projected Burden of Osteoarthritis
and Rheumatoid Arthritis in Australia: A Population‐Level Analysis. Arthritis care
& research, 70(6), 877-883.
Arthritis Australia (2017). Osteoarthritis. Retrieved from:
https://arthritisaustralia.com.au/types-of-arthritis/osteoarthritis/
Australian Institute of Health and Welfare (2019). Osteoarthritis. Retrieved from:
https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis/
contents/what-is-osteoarthritis
Bijlsma, J. W., Berenbaum, F., & Lafeber, F. P. (2011). Osteoarthritis: an update with
relevance for clinical practice. The Lancet, 377(9783), 2115-2126.
Brand, C. (2007). Translating evidence into practice for people with osteoarthritis of the hip
and knee. Clinical rheumatology, 26(9), 1411-1420.
Brand, C. A., Harrison, C., Tropea, J., Hinman, R. S., Britt, H., & Bennell, K. (2014).
Management of osteoarthritis in general practice in Australia. Arthritis care &
research, 66(4), 551-558.
Chapman, L., Brooks, C., Lawson, J., Russell, C., & Adams, J. (2019). Accessibility of
online self-management support websites for people with osteoarthritis: A text
content analysis. Chronic illness, 15(1), 27-40.
Chojnacki, M., Kwapisz, A., Synder, M., & Szemraj, J. (2014). Osteoarthritis: etiology, risk
factors, molecular mechanisms. Postepy higieny i medycyny doswiadczalnej
(Online), 68, 640-652.

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Chou, L., Ellis, L., Papandony, M., Seneviwickrama, K. M. D., Cicuttini, F. M., Sullivan,
K., ... & Wluka, A. E. (2018). Patients’ perceived needs of osteoarthritis health
information: a systematic scoping review. PloS one, 13(4).
Department of Social Services (2015). Aged care assessmwent team (ACAT). Retrieved
from: https://www.myagedcare.gov.au/sites/default/files/2019-04/acat-assessments-
english.pdf
Ganji, R., Pakniat, A., Armat, M. R., Tabatabaeichehr, M., & Mortazavi, H. (2018). The
effect of self-management educational program on pain intensity in elderly patients
with knee osteoarthritis: a randomized clinical trial. Open access Macedonian
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Glyn-Jones, S., Palmer, A. J. R., Agricola, R., Price, A. J., Vincent, T. L., Weinans, H., &
Carr, A. J. (2015). Osteoarthritis. The Lancet, 386(9991), 376-387.
Heidari, B. (2011). Knee osteoarthritis prevalence, risk factors, pathogenesis and features:
Part I. Caspian journal of internal medicine, 2(2), 205.
Heuberger, R. A., & Caudell, K. (2011). Polypharmacy and nutritional status in older
adults. Drugs & aging, 28(4), 315-323.
Hill, C. L., March, L. M., Aitken, D., Lester, S. E., Battersby, R., Hynes, K., ... & Jones, G.
(2016). Fish oil in knee osteoarthritis: a randomised clinical trial of low dose versus
high dose. Annals of the rheumatic diseases, 75(1), 23-29.
Musculoskeletal Australia (2018). Peer Support Groups. Retrieved from:
https://www.msk.org.au/peer-support-groups/

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MyAgedCare (2019). If you need some help around the house or think it’s time to look into
aged care homes, My Aged Care is here to help. Retrieved from:
https://www.myagedcare.gov.au/
Salazar, J., Bello, L., Chávez, M., Añez, R., Rojas, J., & Bermúdez, V. (2014). Glucosamine
for osteoarthritis: biological effects, clinical efficacy, and safety on glucose
metabolism. Arthritis, 2014.
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Shara, M., & Stohs, S. J. (2015). Efficacy and safety of white willow bark (Salix alba)
extracts. Phytotherapy Research, 29(8), 1112-1116.
Sridhar, M. S., Jarrett, C. D., Xerogeanes, J. W., & Labib, S. A. (2012). Obesity and
symptomatic osteoarthritis of the knee. The Journal of bone and joint surgery.
British volume, 94(4), 433-440.
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