A lack of funding is forcing doctors to tell osteoarthritis sufferers to wait on surgery rather than speak with exercise therapists or dieticians.
Around one in eight New Zealand adults have osteoarthritis. Photo: 123RF
Research by Otago University claims that better advice and treatment could reduce pain and save the country up to $1 billion per year in healthcare costs.
Around one in eight Kiwi adults have osteoarthritis, but that's rapidly worsening with an ageing population on the horizon.
Osteoarthritis, also known as OA happens when the cartilage in your joints break down, often in your hips, knees, and spine.
Before she turned 50, Karen Browne was diagnosed with osteoarthritis. The disease causes cartilage in your joints to break down, often in the hips, hands, knees, and spine.
She was told a GP her only option was to have surgery, but hesitant, she looked for other ways to treat her condition.
"Nothing much was given to me by way of advice or intervention. I think something more than surgical means could be offered to help people live better lives," she said.
She waited a few years before seeking advice from Arthritis New Zealand who gave her "self-help advice" and alternative treatments such as exercise.
"I really couldn't afford to spend a lot on my own health care. I found it difficult to find the money to go to a physiotherapist. Often the last thing we spend our money on is our own preventative health and I do think that more could be done in that arena."
Otago University Professor Haxby Abbott's recent research points to fundamental funding flaws into how osteoarthritis is managed by our healthcare system.
"The system is failing to deliver what is internationally the most recommended treatments for this disease."
New Zealand lagged behind international guidelines that show exercise therapy is the best treatment, but when New Zealanders like Karen are first diagnosed, they're told to rest, medicate and then wait five to ten years for surgery.
Professor Abbott said between diagnosis and surgery exercise therapy and weight management interventions was needed, but added this advice was rarely shared, causing people to think surgery was the only option.
Funding barriers made GPs reluctant to refer patients to physiotherapists or dieticians for treatment because there was no subsidy.
"An early intervention programme and co-ordinated care would make a big difference ... up to a billion dollars in value," Professor Abbott said.
His research showed delivering the single most recommended treatment - a high-quality programme of specific exercise therapy - would likely save the health system around $20 million per year by reducing more expensive and ineffective treatments.
It would also result in health gains worth around $450 million per year.
Although surgery was helpful, it should be the last option, not the first port of call, he said.
He said it was not too late to improve the care of people with osteoarthritis, by restructuring how the system runs and is funded.
Arthritis New Zealand backs Abbott's research. Chairperson Peter Larmer said the government must offer better early intervention after diagnosis.
In 2015, the Ministry of Health commissioned a $6 million pilot programme to improve early access to care for musculoskeletal diseases such as osteoarthritis.
Although a subsequent report has been compiled - Arthritis New Zealand says the government has yet to release it.
