On October 11, on the occasion of the 24th World Arthritis Day, a research report focusing on the current status of bone and joint health and diagnosis and treatment habits-"Patient-centered-new insights into bone and joint health management" (hereinafter referred to as "the report" ”) Officially released in Beijing.
The "Report" not only collects the current epidemiological data and diagnosis and treatment guidelines for osteoarthritis, but also incorporates big data from the online consultation platform, and for the first time comprehensively presents the current status of the incidence of osteoarthritis in the entire population in China and the unmet disease management needs. And put forward the model and direction of "establishing patient-centered management of the whole course of osteoarthritis".
This report was supported by Ping An Good Doctor, a medical and health ecological platform, and Mylan, a global pharmaceutical company.
Weng Xisheng, chief physician of Orthopedics Department of Peking Union Medical College Hospital, delivered a speech
The burden of osteoarthritis cannot be ignored
Osteoarthritis is the most common disease among people over 60 years old in the world, and the fourth most disabling disease in the world.
The "Report" shows that the prevalence of osteoarthritis in my country, the number of patients, and the years of life lost by disability have all increased significantly over the time span.
In 2017, the total number of osteoarthritis patients in China reached 61.2 million, and China can be described as the "superpower" of osteoarthritis.
Although it is regarded as a "senile disease", the early occurrence of symptoms such as joint discomfort is concentrated in middle age.
The "Report" reveals that the incidence of patients' conscious joint discomfort increases with age. The first episode is concentrated in the age of 40-54, and it starts to increase significantly at the age of 45-49. There are also nearly 20% of the incidence of joint discomfort in the age group under 45.
Not only that, the overall situation of osteoarthritis presents its own characteristics.
Women are more common than men. Both the prevalence and the average number of uncomfortable joints are higher than men.
From a geographic perspective, the overall prevalence of Southwest, Northwest, Guangdong and Heilongjiang is relatively high. Sichuan Province has the highest incidence of osteoarthritis in my country with a rate of 3.9%.
There are many causes of osteoarthritis. In addition to factors such as age and gender, occupational influence and poor living habits are also important causes of osteoarthritis.
The "Report" pointed out that excessive or insufficient exercise, long standing or sedentary work habits can easily induce osteoarthritis.
Osteoarthritis affects all weight-bearing joints of the body, of which knee joint discomfort is the most common, followed by cervical and lumbar spine.
As the disease progresses, patients are often accompanied by symptoms such as joint pain, soreness, bone friction, stiffness, deformity, and dysfunction, which not only seriously hinder the life of the patient, but also cause a huge psychological burden to the patient.
According to the "Report", up to 94% of patients believe that joint pain is a serious or moderate health problem, 50% of osteoarthritis patients say they are in a state of "extreme anxiety" for a long time, and 25% of osteoarthritis patients often feel "Frustration."
Behind the huge patient population, there are still huge unmet needs for diagnosis and treatment.
Based on the big data of Ping An Good Doctor's consultation platform, the most common medical problems mainly focus on three aspects: expectation of treatment, disease management and treatment costs. Interviewees look forward to improving the quality of life, controlling the medical burden, and are willing to learn more about diseases , In order to help oneself or family member get rid of the shackles of disease better.
It is worth noting that due to the lack of a large-scale, standardized, and cross-population epidemiological survey of bone and joint health, the current overall picture of the current population of osteoarthritis patients in China and the true status of the disease are still full of unknowns, which also brings to the management of osteoarthritis in China. Many challenges have come.
How to base on the needs of patients and solve the burden of disease challenges, so that more patients can benefit from standardized treatment, improve the health of bones and joints, and improve the quality of life, it is urgent for all sectors of society to break the situation.
"Undead cancer" needs to establish a whole disease management system
Osteoarthritis is often referred to as "an undead cancer".
As a degenerative disease, osteoarthritis progresses relatively slowly, and its harm will not bring sudden and fatal effects to patients. It is extremely invisible and is more easily ignored by patients.
The "Report" shows that nearly 90% of osteoarthritis patients lack knowledge of arthritis health, and even lack or wrong understanding of the severity of disease endpoints such as disability. Patients often do not realize that it is a "disease" at the time of onset. In the early stage, patients often lag behind in return and miss the earliest opportunity.
On the one hand, compared with chronic diseases such as cardiovascular disease and diabetes, the daily health care and disease prevention and control of bones, especially bones and joints, are relatively weak.
Although with the popularization of bone health education, the public's awareness of osteoporosis prevention and calcium supplementation has increased, but the awareness of another important aspect of bone health, namely cartilage health management, is still generally lacking.
On the other hand, as far as patients are concerned, even if they seek medical treatment, their attitude towards diagnosis and treatment is not very positive, and their treatment compliance is not strong.
The "Report" revealed that 23% of patients have a relatively negative attitude towards disease diagnosis and treatment, believing that this is a natural phenomenon of the "aging process" and has not taken any measures to reduce joint discomfort.
Among people over 65, the proportion of patients who choose to "recognize their fate" and give up treatment has further increased to nearly 40%.
For this reason, among the bone and joint patients who have experienced medical treatment, 73% of them have no regular follow-up visits.
Regarding the choice of treatment methods, most patients with moderate to severe disease delay to look for interventions until their condition is severe, and give priority to basic treatments such as exercise and massage, and their awareness of treatment methods such as drugs and surgery is not high.
In this regard, Weng Xisheng, vice chairman of the Orthopedics Branch of the Chinese Medical Association and director of the Department of Orthopedics of Peking Union Medical College Hospital, said: "The management of osteoarthritis, a chronic disease, focuses on early diagnosis and early treatment, early intervention, and stepped, personalized treatment strategies. Establishing a gradual whole-course management awareness of'basic treatment-drug treatment-surgical treatment' and guiding patients at different stages to adopt targeted treatment methods according to disease progression should become an important development direction of the current bone and joint health management model."
Experts call for attention to basic treatment, integrate public education, health care policies, and osteoarthritis prevention strategies into regular chronic disease diagnosis and treatment management, implement appropriate osteoarthritis prevention strategies, and timely use exercise therapy, physical therapy, and mobility aids. Move the earliest "treatment window of opportunity" forward to delay disease progression.
Lin Jianhao, director of the Department of Orthopedics and Joints, Peking University People's Hospital, delivered a speech
Lin Jianhao, director of the Department of Osteoarthritis, Peking University People’s Hospital, said: “In view of the irreversible nature of bone and joint diseases, self-management of patients is very important. For patients with early and mid-stage osteoarthritis, it is important to maintain proper weight, adjust lifestyles, and exercise scientifically. Treatment is one of the core methods for the whole-course disease management of osteoarthritis. Targeted and personalized exercise therapy can effectively help patients achieve the goals of reducing pain, improving knee joint function and quality of life."
In addition, for the drug treatment of osteoarthritis, the "Report" also emphasizes the need to adopt individualized treatment strategies, not only to prescribe medicine to the symptoms, but also to people.
Those with obvious pain symptoms can be given non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain.
For patients with joint swelling and in the acute stage, based on disease education and exercise therapy, a small amount of hormones can be injected into the joint cavity to relieve symptoms according to the patient's condition, but it should be noted that the intra-articular injection should not exceed 4 times within a year. Strict aseptic operation is required to avoid infection.
In addition, crystalline glucosamine sulfate and other chondroprotective agents can be used as background treatment for long-term use to relieve pain, repair cartilage, and delay disease progression.
"Three Fulls Strategy" to build healthy bones to help achieve healthy China's strategic goals
The "Healthy China 2030 Planning Outline" particularly emphasizes the importance of disease prevention and health maintenance, clearly focusing on chronic diseases with high mortality and disability, and promoting regular physical exercise especially for people over 60.
The promulgation of relevant programmatic policy documents has played a role in promoting the prevention and control of osteoarthritis and reducing its disease burden.
Weng Xisheng, vice chairman of the Orthopedics Branch of the Chinese Medical Association and director of the Department of Orthopedics of Peking Union Medical College Hospital, pointed out, “Under the guidance of the Healthy China strategy, the healthy bone special action is gradually becoming a reality under the promotion of multiple parties. However, osteoarthritis should be related to cardiovascular and cerebrovascular diseases Chronic diseases such as diabetes and diabetes are included in the national long-term plan for chronic disease management. It is imperative to promote patient-centered disease management throughout the process."
To this end, the "Report" puts forward a "three-all" strategy for the prevention and treatment of osteoarthritis, which is to enhance national awareness by strengthening the science popularization of the whole society, advocate the active participation and promotion of osteoarthritis prevention and control, and build a stepped treatment of joint diseases. The whole process management concept.