http://www.albertahealthservices.ca/scns/page7675.aspx 1

BONE & JOINT

HEALTH STRATEGIC CLINICAL NETWORK

BJH SCN Strategic Planning — Developing a Strategy for Conservative Care of Osteoarthritis (OA)

In Alberta, through the efforts of the Alberta Health Services (AHS) through the Bone and Joint Health Clinical Network (BJHSCN), the Alberta Orthopedic Society (AOS) and the Alberta Bone and Joint Health Institute (ABJHI), hip and knee replacement surgery has been transformed with a standardized, provincial clinical care pathway, central intake mechanisms and case management to support patients through their surgical journey. However given the growing and aging population in Alberta and the increasing prevalence of OA, it’s time to shift our efforts upstream – from an acute episodic model to building a system that meets the needs of the growing number of patients with chronic diseases like OA – to focus on non-surgical, conservative management of OA. The challenges are many: poor application of international OA treatment guidelines by patients and providers; large variation in what is done; limited access to public programs; limited knowledge of what is done in private sector re: chronic OA management; poor navigation in the conservative management realm between public and private systems.

In partnership with Albertans, frontline clinicians, and others, the Alberta BJH SCN is keen to turn its efforts to tackle these challenges and create a coordinated, client centric, conservative OA management system in Alberta. At the recent BJH SCN Core Committee Meeting, Dave Hart, Scientific Director for the BJH SCN presented an overview of the extensive work resulting in the OARSI Guidelines for the Non-Surgical Management of Knee OA. This was linked to the graphic (pictured above) depicting the BJH SCN vision of improving community supports for Albertans with OA. Core Committee Members circulated to various World Café stations. Members provided input and advice to the proposed timeline, process and priorities of advancing models of care for this population – using mild to moderate knee OA to demonstrate proof of concept.

GLA:D Canada In Alberta

GLA:D is an acronym for ‘Good Living with Osteoarthritis in Denmark”, a program originally developed in Denmark. Bone and Joint Canada teamed up with the researchers from Denmark to implement this evidence-based education and exercise program that has shown to reduce the progression of OA in the knee and hip by 36%. In Denmark, the program has been used to help individuals with mild occasional knee and hip pain suggestive of early degenerative symptoms as well as individuals with moderate and even severe symptoms where they are waiting to undergo joint replacement surgery. In each case, the program has been effective in reducing their symptoms and increasing their function with improvement in physical activity noted by many patients one year after participation. GLA:D is a neuromuscular exercise program that has been developed to offload the knee and hip joints by increasing stability thereby reducing pain and increasing the individuals function. The program runs for 12 sessions over 6 weeks and includes education on the pathology of

osteoarthritis as well as facilitated and progressed exercises that improve the muscle function. On May 31 and June 1, the BJH SCN organized and sponsored 35 individuals to attend GLA:D training led by Drs Roos and Skou, originators of the GLA:D program in Denmark. 23 of the attendees are now certified to deliver the GLA:D program and keen to partner with the BJHSCN, The Arthritis Society and Bone and Joint Canada to implement and evaluate the program in Alberta. The intent is to start small, evaluate the program and assess the impact and benefit for Albertans living with OA. The GLA:D programs are set to launch in September 2016 across 11 communities in Alberta.

JUNE 2016

Keeping Albertans

Moving

http://www.albertahealthservices.ca/scns/page7675.aspx 2

From the Scientific Office One of our signature activities for 2016-2016 are the BJH SCN workshops. Through these workshops we plan to enable a multi-stakeholder engagement to discuss salient topics relevant to MSK/bone and joint conditions and health. To ensure an evidence based discussion, we will commission a literature review on the topic and synthesize the knowledge in the form of a white paper report. This report will also be used a foundation upon which, through the workshop, we will generate a position statement or recommendations to inform decision making within the health care system. Our first workshop will focus on the topic of stem cells, addressing the hype and reality of where we are at in terms of our knowledge regarding stem cells and their potential for effective and safe clinical application. Any questions about the Stem Cell workshop – contact Ania Kania-Richmond at anna.kania-richmond@ahs.ca With our shift in focus to conservative management of osteoarthritis, through the Scientific Office we have also been exploring project ideas with several industry partners to support injection of innovations into non-surgical care and management of individuals living with OA. Through this work we aim to be opportunistic, collaborate with the intellectual power – both academic and clinical – that exists in Alberta, and in a target way match potential solutions with identified problems. One of our core purposes as a scientific office is to enable provision of health care services that are evidence based. To that end, we are engaged with the SCN’s working groups on an on-going basis to synthesize and translate knowledge to facilitate uptake into clinical practice. Currently we are working with our Fragility and Stability (F&S) group to help inform their discussions about the application of femoral nerve blocks in treatment of older adults who present with an acute hip fracture.

Osteoporosis Canada Recognizes 25 Canadian Hospitals Offering Fracture Liaison Services (FLS) By Launching an FLS Registry

All 3 of our Alberta Fracture Liaison Service (FLS) sites – Misericordia Community Hospital, Peter Lougheed Centre and the Red Deer Regional Hospital have been recognized as having a Fracture Liaison Service meeting Osteoporosis Canada’s Essential Elements. A Fracture Liaison Service (FLS) is recognized as the most effective program to prevent repeat fractures due to osteoporosis. Osteoporosis Canada’s FLS Registry was launched to profile hospitals across Canada that have implemented effective FLSs. Each of the FLSs showcased on the Registry Map will have demonstrated a commitment to the principles of identification, investigation and initiation of treatment which will ensure that fragility fracture patients will receive the care they need to help prevent future fractures. To learn more about Fracture Liaison Services and to view details of the FLS Registry Map go to http://www.osteoporosis.ca/flsmap

The Arthritis Society’s Walk to Fight Arthritis

Given our commitment to “keep Albertan’s moving”, the Bone and Joint Health Team, with the Alberta Bone and Joint Health Institute (ABJHI) participated in the 2016 Walk to Fight Arthritis on Sunday, June 5, 2016 in Calgary and Edmonton. This national initiative raises awareness and promotes bone and joint health! Our Bone and Joint Health Team raised $2,380 (exceeding our goal!)!!

The Cy Frank Legacy Lectureship — Friday, September 9, 2016 Dr. Allan Bernstein, President and CEO of CIFAR—”The Promise of the Health Sciences in the 21st Century—A Revisit”. LOCATION: Health Sciences Centre, Libin Theatre, U of C. TIME: 2:00 pm (Lecture) 3:30 pm (Reception) For more information or to RSVP, please contact anna.urbanska@ucalgary.ca