CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
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understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Osteoarthritis
This tool provides information to facilitate the management of osteoarthritis (general) in adults.
Focused examination
1. Patient History
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Assess level of concern for major structural or other pathologies. If required, refer to an appropriate healthcare provider.
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Identify and assess other conditions and co-morbidities. Manage using appropriate care pathways.
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Address prognostic factors that may delay recovery.
Major structural or other pathologies may be suspected with certain signs and symptoms (red flags):
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History of trauma, prolonged morning joint-related stiffness, rapid worsening of symptoms or the presence of a hot, swollen joint, history of malignancy, vertebral infection, osteoporotic fractures, traumatic fracture, myelopathy, brain haemmorrhage/mass lesion, inflammatory arthritis
Examples of other conditions/co-morbidities:
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Physical conditions: back pain, headache
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Psychological symptoms: depression, anxiety
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Co-morbidities: diabetes, heart disease
Examples of prognostic factors that may delay recovery:
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Symptoms of depression or anxiety, passive coping strategies, job dissatisfaction, high self-reported disability levels, disputed compensation claims, somatization
2. Physical Examination
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Assess levels of concern regarding major structural or other pathologies.
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Diagnose osteoarthritis clinically without investigations if a person is over 45 years of age AND has activity-related joint pain AND has either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 minutes.
3. Management
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Offer information on nature, management, and the course of osteoarthritis.
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Discuss the range of effective interventions with the patient and, together, select a therapeutic intervention.
Patient Handouts
Non-pharmacological management of osteoarthritis
Provide structured patient education (advice to stay active, reassurance, promote and facilitate return to work and normal activities, self-care advice) and any one of the following therapeutic interventions*:
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Consider local muscle strengthening and general aerobic exercise
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Consider heat/cold
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Consider manipulation and stretching (particularly for osteoarthritis of the hip)
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Consider interventions to achieve weight loss for those who are overweight or obese
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Consider transcutaneous electrical nerve stimulation (TENS) for pain relief
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Consider appropriate footwear with shock-absorbing properties
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Consider assessment for bracing/joint supports/insoles
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Consider assistive devices (e.g., walking sticks and tap turners)
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Do not offer acupuncture
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Do not offer glucosamine or chondrotin products
Pharmacological management of osteoarthritis
Provide structured patient education (advice to stay active, reassurance, promote and facilitate return to work and normal activities, self-care advice) and any one of the following therapeutic interventions*:
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Consider oral analgesics
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Consider topical treatments
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Consider non-steroidal anti-inflammatory drugs and highly selective COX-2 inhibitors
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Consider intra-articular injections
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Do not offer intra-articular hyaluronan injections
Invasive management of osteoarthritis
Provide structured patient education (advice to stay active, reassurance, promote and facilitate return to work and normal activities, self-care advice):
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Do not refer for arthroscopic lavage and debridement unless the person has knee osteoarthritis with a clear history of mechanical locking (as opposed to morning joint stiffness, 'giving way' or X-ray evidence of loose bodies)
*Interventions are recommended if guidelines used terms such as ‘recommended for consideration’ (e.g., ‘offer’, ‘consider’), ‘strongly recommended’, ‘recommended without any conditions required’, or ‘should be used’. Recommendations from low-quality evidence are not listed.
Care Pathway for the management of osteoarthritis
4. Reevaluation and Discharge
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Reassess the patient at every visit to determine if: (1) additional care is necessary; (2) the condition is worsening; or (3) the patient has recovered.
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Monitor for any emerging factors that may delay recovery.
5. Referrals and Collaboration
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Refer the patient to an appropriate healthcare provider for further evaluation at any time during their care if they develop worsening symptoms or new physical or psychological symptoms.
Additional Resources
