Kathryn Miller, MD, associate professor, General Internal Medicine, is the lead author of a new study in Osteoarthritis and Cartilage Open that assesses the successes and challenges of the University of Wisconsin (UW) osteoarthritis management program (OAMP).

International osteoarthrosis (OA) care guidelines recommend a holistic approach to treatment—including education, self-management support, exercise advice and weight management recommendations—before pharmacological or surgical interventions. But the care many patients receive does not follow these guidelines, remaining piecemeal and partially or wholly ineffective.

In response, medical centers around the world have developed guideline-based OAMPs.

The UW program, which Dr. Miller helped establish in 2017, primarily serves patients with knee and hip OA, and is a true multidisciplinary effort. The clinical team comprises two DOM primary care physicians—Dr. Miller and Erin Davis, MD, assistant clinical professor—and two advanced practice providers (APPs). The UW Department of Orthopedics provides the facilities, nurses and budget. Physical therapists, registered dieticians, and behavioral health specialists see each patient as needed.

Many of the patients have a higher body mass index (BMI), putting them at higher surgical risk for total joint replacement. Over the course of the study, each made between one and six visits to the OAMP. As a result, the study’s authors noted, “Patients who started […] with higher pain levels and higher BMI were more likely to experience improvements in both.”

Moreover, the OAMP saw a six-fold increase in referrals by the study’s completion in 2022—a clear indication of program demand and sustainability.

“The thing I’m most proud of […] is that we’ve really developed a home for these patients,” said Dr. Miller. “They no longer have to be shuttled from specialist to specialist in order to meet their needs.”

In the 60-second video below, she reflects further on the recent study and the future of the OAMP:

The study’s co-authors include Christine Bartels, MD, associate professor and chief, Rheumatology, and internal medicine residents Divya Vundamati, MD, PG-2, and Marley Foertsch, MD, PG-3.

Photo and video credit: Clint Thayer/Department of Medicine.