Background Due to its chronic nature and its associated impact on physical function and life quality, arthritis in its various forms imposes a significant burden on society. Objective To critically review and evaluate: (1) what has been documented about the burden of arthritis, (2) what is being done in treatment, and (3) what might be done at the primary, secondary and tertiary prevention levels to offset this burden. A further objective was to offer some evidence-based strategies for reducing the prevalence of arthritis and its disability-related complications, including screening, high-quality patient education and self-management programmes, advocacy, and research. Method An in-depth literature review and systematic analysis of the related literature was conducted. Results Although steps have been taken both in the context of the American Arthritis Plan and the Healthy People 2010 arthritis objectives, more needs to be done to reduce the increasing burden of arthritis through prevention. One or more of the currently documented intervention strategies may assist in ameliorating, or possibly preventing, the extent of arthritis-related disability.
Centers for Disease Control and Prevention (CDC).Arthritis prevalence and activity limitations—United States, 1990 . Morbidity and Mortality Weekly Report, 1994: 43: 433–438 .
2.
Centers for Disease Control and Prevention (CDC).Impact of arthritis and other rheumatic conditions on the health-care system . Morbidity and Mortality Weekly Report, 1999: 48: 349–353 .
3.
Helmick CG , Lawrence RC , Pollard RA , et al. Arthritis and other rheumatic conditions: Who is affected now, who will be affected later? National Arthritis Data Workgroup . Arthritis Care and Research, 1995: 8: 203–211 .
4.
Lawrence RC , Helmick CG , Arnett FC , et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States . Arthritis and Rheumatism, 1998: 41: 778–799 .
5.
Centers for Disease Control and Prevention (CDC).Current trends: Prevalence of disabilities and associated health conditions—United States, 1991–1992 . Morbidity and Mortality Weekly Report, 1994b: 43: 730–731, 737–739 .
6.
Dunlop DD , Manheim LM , Song J , Chang RW.Arthritis prevalence and activity limitations in older adults . Arthritis and Rheumatism, 2001: 44: 212–221 .
7.
Centers for Disease Control and Prevention (CDC).Targeting Arthritis: The Nations Leading Cause of Disability. At a Glance Behavioral Risk Factor Surveillance System, 2001. Atlanta, GA: CDC , 2003.
8.
Brooks PM.Impact of osteoarthritis on individuals and society: How much disability? Social consequences and health economic implications . Current Opinion in Rheumatology, 2002: 4: 573–577 .
9.
Elders MJ.The increasing impact of arthritis on public health . Journal of Rheumatology, 2000: 27: 6–8 .
10.
Michaud K , Messer J , Choi HK , Wolfe F.Direct medical costs and their predictors in patients with rheumatoid arthritis: A three-year study of 7,527 patients . Arthritis and Rheumatism, 2003: 48: 2750–2762 .
11.
Yelin EH , Felts WR.A summary of the impact of musculoskeletal conditions in the United States . Arthritis and Rheumatism, 1990: 33: 750–755 .
12.
Yelin E.Arthritis: The cumulative impact of a common chronic condition . Arthritis and Rheumatism, 1992: 35: 489–497 .
13.
[No authors listed]. Prevalence of leisure-time physical activity among persons with arthritis and other rheumatic conditions—United States, 1990–1991 . Morbidity and Mortality Weekly Report, 1997: 46: 389–393 .
14.
LaPlante MP.Data on Disability from the National Health Interview Survey, 1983–1985. Washington, DC: National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education (DOE) , 1988.
15.
Felts W , Yelin E.The economic impact of the rheumatic diseases in the United States . Journal of Rheumatology, 1989: 16: 867–884 .
16.
Centers for Disease Control and Prevention (CDC).Update: Direct and indirect costs of arthritis and other rheumatic conditions—United States, 1997 . Morbidity Mortality Weekly Report, 2004: 14: 388–389 .
17.
Trupin L , Sebesta DS , Yelin E. , et al. Trends in Labor Force Participation Among Persons With Disability, 1983–1994. Disability Statistics Report 10. Washington, DC: DOE, NIDRR , 1997.
18.
Bradley LA , Wegener ST , Belza BL , et al. Pain management interventions for patients with rheumatic diseases. In: J Melvin and G Jensen (Eds), Rheumatologic Rehabilitation Series Volume I: Assessment and Management (pp. 259–278). Rockville, MD: American Occupational Therapy Association , 1998.
19.
Frank RG , Hagglund KJ.Mood disorders. In: ST Wegener (Ed.), Clinical Care in the Rheumatic Diseases (pp. 125–130). Atlanta, GA: American College of Rheumatology , 1996.
20.
Dunlop DD , Lyons JS , Manheim LM , Song J , Chang RW.Arthritis and heart disease as risk factors for major depression: The role of functional limitation . Medical Care, 2004: 42: 502–511 .
21.
Wolf F.The natural history of rheumatoid arthritis . Journal of Rheumatology, 1996: 23(Suppl. 44): 13–22 .
22.
Centers for Disease Control and Prevention (CDC).State differences in reported healthy days among adults—United States, 1993–1996 . Morbidity Mortality Weekly Report, 1998a: 47: 239–243 .
23.
Centers for Disease Control and Prevention (CDC).Targeting Arthritis: The Nation's Leading Cause of Disability. At-a-Glance, 1998. Atlanta, GA: Technical Information and Editorial Services Branch, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) , 1998.
24.
Muchmore L , Lynch WD , Garner HH , Williamson T , Burke T.Prevalence of arthritis and associated joint disorders in an employed population and the associated healthcare, sick leave, disability, and worker's compensation benefits cost and productivity loss of employers . Journal of Occupational and Environmental Medicine, 2003: 45: 369–378 .
25.
Felson DT.An update on the pathogenesis and epidemiology of osteoarthritis . Radiology Clinics of North America, 2004: 42: 1–9 .
26.
Rao JK , Hootman JM.Prevention research and rheumatic disease . Current Opinion in Rheumatology, 2004: 16: 119–124 .
27.
Centers for Disease Control and Prevention (CDC). NCCDPHP, Division of Adult and Community Health, Health Care and Aging Studies Branch, Atlanta, GA: unpublished data, 1990.
28.
Centers for Disease Control and Prevention (CDC).Prevalence and impact of arthritis among women. United States, 1989–1991 . Morbidity Mortality Weekly Report, 1995: 44: 329–334, 517–518 .
29.
Centers for Disease Control and Prevention (CDC).Prevalence and impact of arthritis by race and ethnicity—United States, 1989–1991 . Morbidity Mortality Weekly Report, 1996: 45: 373–378 .
30.
Jarvis JN , Cleland SY.Rheumatic disease in Native American children: Opportunities and challenge . Current Rheumatology Report, 2003: 5: 471–476 .
31.
Escalante A , del Rincon I , Mulrow CD.Symptoms of depression and psychological distress among Hispanics with rheumatoid arthritis . Arthritis Care and Research, 2000: 13: 156–167 .
32.
Hootman JM , Sniezek JE , Helmick CG.Women and arthritis: Burden, impact and prevention programs . Journal of Women's Health and Gender Based Medicine, 2002: 11: 407–416 .
33.
Wilson MG , May DS , Kelly JJ.Racial differences in the use of total knee arthroplasty for osteoarthritis among older Americans . Ethnic Diseases, 1994: 4: 57–67 .
34.
Felson DT.Epidemiology of hip and knee osteoarthritis . Epidemiology Reviews, 1988: 10: 1–28 .
35.
Hochberg JC.Osteoarthritis. In: AJ Silman and JC Hochberg (Eds), Epidemiology of the Rheumatic Diseases (pp. 257–288). Oxford: Oxford University Press , 1993.
36.
US Department of Health and Human Services (HHS).Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: HHS, CDC , 1996.
37.
Dominick KL , Ahern FM , Gold CH , Heller DA.Health-related quality of life among older adults with arthritis . Health and Quality of Life Outcomes, 2004: 2: 5–13 .
38.
Brady TJ , Kruger J , Helmick CG , Callahan LF , Boutagh ML.Intervention programs for arthritis and other rheumatic diseases . Health Education and Behavior, 2003: 30: 44–63 .
39.
Warsi A , LaValley MP , Wang PS , Avorn J , Solomon DH.Arthritis self-management education programs: A meta-analysis of the effect on pain and disability . Arthritis and Rheumatism, 2003: 48: 2207–2213 .
40.
Riemsma RP , Kirwan JR , Taal E , Rasker JJ.Patient education for adults with rheumatoid arthritis . Cochrane Reviews, 2003: 2: CD003688.
41.
Schmitt H , Brocai DR , Lukoschek M.High prevalence of hip arthrosis in former elite javelin throwers and high jumpers: 41 athletes examined more than 10 years after retirement from competitive sports . Acta Orthopedica Scandinavica, 2004: 75: 34–39 .
42.
Sinkov V , Cymet T.Osteoarthritis: understanding the pathophysiology, genetics, and treatments . Journal of the National Medical Association, 2003: 95: 475–482 .
43.
Karlson EW , Mandl LA , Aweh GN , Sangha O , Liang MH , Grodstein F.Total hip replacement due to osteoarthritis: The importance of age, obesity, and other modifiable factors . American Journal of Medicine, 2003: 114: 93–98 .
44.
Felson DT , Zhang Y , Anthony JM , et al. Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study . Annals of Internal Medicine, 1992: 116: 535–539 .
45.
Weinblatt ME.Rheumatoid arthritis: Treat now, not later! (Editorial)Annals of Internal Medicine, 1996: 124: 773–774 .
46.
Lorig KR , Mazonson PD , Holman HR.Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs . Arthritis and Rheumatism, 1993: 36: 439–446 .
47.
Centers for Disease Control and Prevention (CDC).Preventing Chronic Diseases: Investing Wisely in Health. Preventing Arthritis Pain and Disability. Online. Available: www.cdc.gov/nccdphp (accessed 27 July 2006).
48.
Leong AL , Euller-Ziegler L.Patient advocacy and arthritis: Moving forward . Bulletin of the World Health Organization, 2004: 82: 115–120 .
49.
Daltroy L.Doctor-patient communication in rheumatological disorders . Bailliere's Clinical Rheumatology, 1993: 7: 221–239 .
50.
Holman HR.What could ideal care look like? In: FJ Manning and JA Barondess (Eds), Changing Health Systems in Rheumatic Diseases (p. 35-46). Washington, DC: Institute of Medicine Press , 1996.
51.
Kim HA , Bae YD , Seo YI.Arthritis information on the Web and its influence on patients and physicians: A Korean study . Clinical and Experimental Rheumatology, 2004: 22: 49–55 .
52.
Centers for Disease Control and Prevention (CDC).Direct and indirect costs of arthritis and other rheumatic conditions—United States, 1997 . Morbidity Mortality Weekly Report, 2003: 52: 1124–1127 .
53.
Dunlop DD , Manheim LM , Song J , Chang RW.Health care utilization among older adults with arthritis . Arthritis and Rheumatism, 2003: 49: 164–171 .
54.
Marks R , Allegrante JP.Non-operative management of osteoarthritis . Critical Reviews in Physical and Rehabilitation Medicine, 2001: 13: 1–28 .
55.
Alamanos Y , Drosos AA.Epidemiology of adult rheumatoid arthritis . Autoimmune Review, 2005: 4: 130–136 .
56.
Soubrier M , Dougados M.How to assess early rheumatoid arthritis in daily clinical practice . Best Practices Research in Clinical Rheumatology, 2005: 19: 73–89 .
57.
Sokka T.Work disability in early rheumatoid arthritis . Clinics in Experimental Rheumatology, 2003: 21: S71–S74 .
58.
Yelin E , Cisternas MG , Pasta DJ , Trupin L , Murphy L , Helmick CG.Medical care expenditures and earnings losses of persons with arthritis and other rheumatic conditions in the United States in 1997: Total and incremental estimates . Arthritis and Rheumatism, 2004: 50: 2317–2326 .
59.
Wolfe R , Michaud K.Severe rheumatoid arthritis (RA), worse outcomes, comorbid illness, and sociodemographic disadvantage characterize RA patients with fibromyalgia . Journal of Rheumatology, 2004: 31: 695–700 .
60.
Mapel DW , Shainline M , Paez K , Gunter M.Hospital, pharmacy, and outpatient costs for osteoarthritis and chronic back pain . Journal of Rheumatology, 2004: 31: 573–583 .
61.
Centers for Disease Control and Prevention. Racial/ethnic differences in the prevalence and impact of doctor-diagnosed arthritis—United States , 2002. Morbidity and Mortality Weekly Report, 2005: 53: 119–123 .
62.
Maradit-Kremers H , Crowson CS , Nicola PJ , Ballman KV , Roger VL , Jacobsen SJ , Gabriel SE.Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: A population-based cohort study . Arthritis and Rheumatism, 2005: 52: 402–411 .
63.
Finch WR.Mortality in rheumatoid disease . Journal of Insurance Medicine, 2004: 36: 200–212 .
64.
Sowers M.Epidemiology of risk factors for osteoarthritis: Systemic factors . Current Opinion in Rheumatology, 2001: 13: 447–451 .
65.
Treharne GJ , Hale ED , Lyons AC , Booth DA , Banks MJ , Erb N , Douglas KM , Mitton DL , Kitas GD.Cardiovascular disease and psychological morbidity among rheumatoid arthritis patients . Rheumatology2005: 44: 241–246 .
