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Arthritis Awareness Advocacy Campaign

Arthritis Awareness Advocacy Campaign. Changing The Way We Look At Arthritis. INTRODUCTION.

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Arthritis Awareness Advocacy Campaign

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  1. Arthritis Awareness Advocacy Campaign Changing The Way We Look At Arthritis

  2. INTRODUCTION Created with the help and suggestions of the Dr. Brix Pujalte, Dr. Paul San Pedro, POA Board, POA Southern Luzon Chapter, POA Western Visayas Chapter, POA midyear business meeting participants, POA Philortho e-groups participants, The Philippine Hip and Knee Society and Advanced Orthopedics for Joint Replacement. This presentation is still evolving and your input and suggestions are most welcome.

  3. Need to Know: Arthritis Information Resources for Doctors and Patients Best and readily available on internet: Complete clinical practice guideline for the management of arthritis – almost perfect but not designed for Philippine referral system (British Columbia) http://www.bcguidelines.ca/gpac/pdf/oa.pdf Ten things you need to know about arthritis Philippines and other printable or downloadable materials for Philippine setting www.philortho.org new site coming soon!!!

  4. Arthritis Statistics in The Philippines • DOH 2008 Estimate: There are 11 Million Filipinos with Osteoarthritis (based on a prevalence rate of 16%) • About 50% of 65 years and older have symptoms of arthritis

  5. United States Joint Replacement Stats U.S. – American Academy of Orthopedic Surgeons: Stats in the year 2008 700,000/year Total Joint Replacements expected to double in ten years

  6. Philippine Hip and Knee Society Joint Replacement Stats There were more than 1000 joint replacements done/year in 2007 and 2006. There were only 900 joint replacement done in 2008 Philippines an appalling 0.12% of the US Shrinking Tip of the Iceberg Joint replacement is also done for AVN and Fractures – Actual TJR for arthritis is even less

  7. Tip of the Iceberg We know how many joint replacements We do not know the actual number of Filipinos with arthritis We also do not know how many have not consulted a doctor with symptoms of arthritis

  8. Why is the tip of the iceberg getting smaller?

  9. Ortho Surgeon’s Reflex Assumptions on the Shrinking Tip of the Iceberg • “Masyadong kasing mahal magpaopera” • “Bagsak kasi economy natin” • “Mahal ang mga Implants” Assumption: “Cost is the major factor for the decline in Arthritis surgery.”

  10. Is there Logic on Cost of Surgery Theory? There should be similar effects on other surgical procedures of similar cost and benefit/risk ratio if COST is the major reason for low numbers or decline

  11. Why is there a Plastic surgery boom despite similarity in cost/risk ratio?Examples: Liposuction: 200,000 pesos (>1,500 cases/year) Breast augmentation: 180,000 (>1,000 pairs/year)

  12. Perception and Awareness • Perception of Benefit is Low or Unknown • “It ain’t compellin if it ain’t sellin”. Cancer/Fracture • Advertising can be good if it is truthful • Freedom of speech – basic right of everyone and this includes advertising

  13. RETHINKING OUR ASSUMPTIONS AND OBSERVATIONS Is the tip of the iceberg the only thing that is shrinking?

  14. Classic Observations on Arthritis Awareness • Common belief: Arthritis comes naturally with age and we just have to accept it with little or no treatment. “Matanda na naman ako” or “Kung ayaw nyo ako pagamot eh di Hwag”

  15. Lacking Information • Many are not aware which treatment options for arthritis are available, approved and safe? • Most do not know where to get help or guidance for credible information.

  16. More Classic Observations on Arthritis Patients • When about to see a doctor, they do not know what kind of doctor to consult. • Even when already consulting a doctor many will persist with their pre-determined option (typical of elderly and not just arthritis patients)

  17. General “Perception” about Orthopedic Surgeons • Often not motivated to treat arthritis unless severe/surgical • Potential to be aggressive in favor of surgery even when other good options are available

  18. Science of Persuasion Don’t Steer The Horse, Ride with it. “Tama po kayo Lola….Noon” Always agree initially because they do not want to be viewed as ignorant or stupid if you say they are wrong. Choice of words is crucial

  19. From Bad to Worst These observations have been around for many years. Arthritis consult and surgery was assumed to be increasing because of population growth. What has changed in the last few years to cause a decline or worsening in the awareness of arthritis/tip of the iceberg?

  20. BFAD/DOH Advertising drugs that by law require prescriptions should must have warnings regarding complication risk. WARNING EXAMPLES: “Smoking is hazardous to your health” “Consult a doctor before trying this medication” “Cancer of the joint presents also as joint pain too”

  21. The Rise or Dumping of Glucosamine in the Philippines • So many have tried it and continue to take it. US relatives send it or as pasalubong • Some doctors still prescribe it • How much has it affected the way we make choices for arthritis treatment? • NO APPROVED THERAPEUTIC CLAIM

  22. Excellent Study on the Placebo -Glucosamine • Effect of glucosamine sulfate on hip osteoarthritis: a randomized trial. Feb 2008 Annals of Internal Medicine Rozendaal RM, Koes BW, van Osch GJ, Uitterlinden EJ, Garling EH, Willemsen SP, Ginai AZ, Verhaar JA, Weinans H, Bierma-Zeinstra SM. • Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands • 222 patients 2 year study • CONCLUSION: Glucosamine sulfate was no better than placebo in reducing symptoms and progression of hip osteoarthritis

  23. 2008 - Still Consistent Good Outcome -Joint Replacement- • Archives of Internal Medicine 2008- Hamel, M.D., M.P.H., and colleagues studied medical decision-making and treatment outcomes in 174 patients age 65 and older with severe osteoarthritis of the hip or knee. “Excellent outcomes from joint replacement surgery in elderly patients with severe hip or knee osteoarthritis corroborate and extend the findings of previous studies. "

  24. Why did the other half of U.S. joint replacement study cited in Archives of Internal Medicine 2008 NOT have surgery? CONCLUSION: Close to half (45 percent) of patients who did not have surgery reported that surgery was NOT offered to them as a potential treatment by their family physician.

  25. WE NEED TO ACT NOW ON ARTHRITIS AWARENESS! • FIGHT IGNORANCE / DOCTORS INCLUDED • CORRECT THE CULTURE OF GIVING UP ON THE ELDERLY OR THEIR DISEASES (Walang Iwanan) • FIGHT MISINFORMATION ABOUT FALSE CURES/SUPPLEMENT • PROMOTE DOCTORS AS ARTHRITIS AUTHORITY/GUIDE • DISCOURAGE DRUG COMPANIES FROM PROMOTING THEIR PRODUCTS AS THE FIRST LINE IN THE MANAGEMENT OF ARTHRITIS A DOCTOR’S CONSULT OR WARNING

  26. Objectives • Promote an advocacy for the awareness of osteoarthritis and its social, economic and health complications impact • Correct misconceptions and misinformation about the treatment of osteoarthritis. • Promote Doctors as the primary source of guidance in the management of Osteoarthritis

  27. Why an Advocacy Campaign? • Causes are self propagating and is not just about information sharing • Depends on our conscience or social obligation to our community • Viral Ex. That Black man for President (Stood for anti-racist, liberal youthful leadership and hope. If he can be US President then anyone can)

  28. FIRST 3 KEY CAMPAIGN MESSAGES • That Arthritis is a painful and disabling disease that requires early and urgent attention • That anyone can also help this cause by joining the campaign by registering and/or volunteering to help • That Filipino Doctors can be trusted to competently help arthritis victims

  29. Vision • A significant number of Filipinos are aware that arthritis is a disease that requires understanding, early attention and proper treatment • Credible, competent and up to date sources of information about arthritis and its treatment is available to all Filipinos • The first or earliest management of arthritis is synonymous with a doctors consult • All the major players in the health sector, doctors, the pharmaceutical companies, surgical implant companies, government health agencies are all proactive allies in the campaign for arthritis awareness and its treatment

  30. Meet OrthoDoc Coming Soon: Steroid Injector Exercise Regimen Viscos Lubricator Robojoint Transformer FamilyDoc and Captain Internist

  31. AAA Facebook Presence since Feb 2009 www.causes.com/walangiwanan • Walang Iwanan Campaign Started • 570 Supporters and growing • Drs. Tanchuling, Kuh, Agbayani, Allan De Vera, AOJR • Supported and spread by non doctors

  32. Ten Must Know Things about OA • The many types and some common forms of arthritis? • Defining OA vs. other types of arthritis • Significant statistics on OA – prevalence/ gender/ age • Most commonly affected joints • Some common specific symptom of OA • Complications related to arthritis/ delayed treatment • 5 common risk factors? (weight, injury, age etc.) • When and Who to Consult for OA • What are the accepted or approved treatment options?/What are not accepted? • Is there a cure? Or is Surgery a good option?

  33. Arthritis Awareness AdvocacyAAAKaya TandaanWalang IwananSa Sakit ng Kasukasuan

  34. Target Dates September - October 2009 A Major Event and Fund Raising Campaign November - December 2009 Mass Media Public Promotion Launch • Nationwide Billboard Campaign • Nationwide comics or flyer distribution • Nationwide radio and tv launch • Magazine and Newspaper publication • Hospital presence of mascots

  35. How Can You Help The AAA? • Commit to be an advocate of arthritis by signing and answering: Are you an advocate of arthritis awareness? • Register and provide contact details for: a) Arthritis Advocacy Club Membership b) E-mail and Text updates c) Support and Promotion ideas d) Gathering feedback and suggestions • Recruit others by getting them to commit and register with the campaign through the website or cell phone

  36. Help in your own Way • Talk about it • E-mail it/Blog it • Mention it to all your patients and med reps • Include a slide or two in all your lectures. • Spread it to all our allies like drug companies, hospitals, civic organizations and government • Wear T-shirts, Wristbands with cause logo/name • Donate money/time • Introduce connections

  37. THE END “A Dream you dream alone is just a dream. A dream wedream together is reality” -John Lennon- Dr. Brix Pujalte POA President Dr. Paul San Pedro Co Chair AAA Dr. Benigno Agbayani Jr. Co-Chair AAA The Philippine Orthopedic Association and Philippine Hip and Knee Society arthritisadvocacy@yahoo.com Globe: 09152806122 or Smart: 09291594311 e-mail: iggyagbayani@yahoo.com

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