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Obesity-related knee osteoarthritis: a role for the rheumatology advanced nurse practitioner in Ireland

09 May 2024
Volume 33 · Issue 9


Arthritis is the leading cause of disability in Ireland with knee osteoarthritis the most common presentation. One in five women and one in 10 men over the age of 60 in Ireland are diagnosed with osteoarthritis. The causative factors are multifactorial, but the increasing incidence of obesity is contributing greatly to the occurrence of osteoarthritis of the weight-bearing joints. The rheumatology advanced nurse practitioner is an autonomous clinical practitioner and potential solution to the growing numbers of people needing interventions for osteoarthritis, due to their ability to assess, diagnose, treat, and discharge these patients who ordinarily would be assessed from a medical waiting list. As obesity is becoming increasingly prevalent, it is important to address this with the patient cohort to try to reduce the burden of disease and treat not only the symptomatic knee osteoarthritis but the causative factors and provide patient-centred care.

Owing to increased demand on the Irish healthcare service and economic constraints, an effort has been made to seek alternative solutions for patients living with chronic illness, including those with rheumatic and musculoskeletal diseases (RMDs) (Carney, 2016; Department of Health (DH), 2016). The role of the rheumatology advanced nurse practitioner (ANP) in an Irish healthcare context is to improve patient flow, to shorten outpatient waiting lists, facilitate earlier discharge, and provide early, appropriate access to services (DH, 2019). The DH has sought to increase the percentage of nurse practitioners in Ireland. Several demonstrator sites were used to evaluate the development of roles and the implementation of posts (DH, 2019). The programme introduced an additional 27 rheumatology candidate advanced nurse practitioner (cANP) posts in October 2017 across the seven hospital groups in Ireland. The rheumatology ANP is an expert practitioner who can provide patient education, retrieve and record a medical/surgical/psychosocial patient history, assess presenting symptoms, diagnose, treat, and discharge patients autonomously, thus reducing the burden on rheumatology medical clinics (DH, 2019). With the increasing rates of obesity, the rheumatology ANP is a useful addition to the multidisciplinary team to tackle obesity-related knee osteoarthritis. The clinical role of the ANP on the rheumatology team has fostered and enhanced the management of knee osteoarthritis in the Irish healthcare setting.

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