An Otago researcher is setting the wheels in motion to seek out much-needed change in the way osteoarthritis, which affects increasing numbers of people, is treated in New Zealand.

Professor Haxby Abbott is cycling the length of New Zealand over the next month peddling the message highlighted in his recent research, funded by the Health Research Council. 

That is, that rates of osteoarthritis are rising rapidly, the health system is not delivering the recommended treatments efficiently and that providing high-quality care for people with the disease would result in large health gains for New Zealanders with huge savings for the health sector.

Results from his recent research show that if an evidence-based exercise therapy programme was rolled out nationally for people with osteoarthritis, it would cost about $25 million annually but would result in savings to the health system and significant health gains of more than $450 million annually.

The intrepid professor considers there’s no better way to spread the word than walking (or pedalling) the talk and he begins his #rOAdtrip for osteoarthritis (OA) on 17 February. Over the next month he will cycle the length of New Zealand, 3000km from Cape Reinga to Bluff, on the 2020 Tour Aotearoa Brevet.

“Along the way I will stop to talk to individuals and communities, raising public awareness, policy questions and fundraising for further research into the disease.”

Osteoarthritis is a leading cause of health problems and costs in New Zealand.  Professor Abbott and Dr Ross Wilson, researchers in the Department of Surgical Sciences, explain the burden of this disease is rising as a result of population ageing, rising obesity, increasing injury rates and earlier onset of disease.

“The New Zealand health system is already struggling to meet demand for joint replacement surgeries and will be placed under greater pressure by rising rates of OA,” Professor Abbott says.

Professor Abbott’s research with Dr Wilson and colleagues, shows the number of people with knee joint osteoarthritis has been increasing rapidly since 2013 when 280,000 New Zealanders suffered from the disease. 

On current projections, they estimate more than 500,000 people will have osteoarthritis by 2038.

This transfers into huge health problems for many and increasing demand for joint replacements.  The research estimates knee joint replacements will increase by 77 per cent between 2013 and 2038 and total health system costs will increase by 86 per cent, unless preventive action is taken.

“Osteoarthritis is not only having a hugely detrimental effect on people’s health, it’s also costing the health system millions annually, but there are answers that can turn these figures around,” Professor Haxby explains.

“The health system is failing to deliver the most recommended treatments and many treatments that are not recommended are routinely funded and are being delivered excessively such as long-term use of anti-inflammatory medications, opioids and repeat injections of corticosteroids.”

Exercise therapy, physical activity, weight loss (where appropriate), patient education and self-management are widely accepted internationally as the best treatment for osteoarthritis. 

Joint replacement surgery is considered effective and cost-effective for people whose osteoarthritis has progressed in severity despite those treatments.

The research found that delivering all the recommended interventions (exercise therapy, physical activity, weight loss, patient education and self-management) would result in significant health gains of more than 10,000 quality-adjusted life years annually (a single quality-adjusted life year is equal to one year of full health).

The estimates show this would be cost effective. It would cost $150 million a year to deliver all of the first-line treatments through co-ordinated programmes with a net benefit, in terms of cost savings and health gains to the population, of $400 million a year.

Professor Abbott’s research shows adequate delivery of the first-line treatments will reduce demand for less cost-effective treatments, reaping potential cost savings for the public healthcare system.

“The monetary benefit estimates we have reported are on the conservative side, as they do not include all of the cost savings from other areas of the health system, or increases in productivity, both of which we have demonstrated in earlier research.”

Professor Abbott will raise money for osteoarthritis research on his cycling #rOAdtrip. Donations can be made at www.bit.ly/MOAdonations