579 Audit to Measure if >5% Reduction in Weight Occurred, as Recommended by the National Institute of Health and Clinical Excellence (NICE), for Patients Suffering from Osteoarthritis Before Their Scheduled Total Joint Replacements, at Darwen Health Link Surgery

Abstract

Aim
Osteoarthritis causes damage to synovial joints, manifesting as pain, loss of function, and disability. A high BMI is correlated with an increased incidence of osteoarthritis, for which NICE recommends a >5% (ideally >10%) decrease in baseline weight to improve pain and functionality. This audit aims to measure Darwen Health Link’s adherence to NICE guidelines 226 “Osteoarthritis in over 16s: diagnosis and management” for the management of osteoarthritis patients regarding weight-loss.

Method
This audit analysed 15 osteoarthritis patients with a BMI>30 who underwent total joint replacements from November 2021 to November 2022. Patient records were analysed for their weight management from 3-12 months prior to surgery, up till their surgery period to assess: if weight-loss advice was provided, and if >5% weight-loss took place. Standards were designated per clinician recommendations and NICE guidelines.

Results
All osteoarthritic patients (n = 15) were given weight-loss advice at presentations before surgery. However, only 20% (n = 3) of patients lost >5% of their baseline weight before their joint replacements, against the 50% standard. Therefore, interventions to improve weight-loss in patients and clinician guidance were implemented. These include a targeted poster, detailed weight-loss advice packs for patients, and clinician education about weight-loss programmes available locally.

Conclusions
The first part of the audit indicates suboptimal performance by Darwen Health Link. Their performance will be re-audited in 3 months post-interventional implementation. Reducing osteoarthritis’s burden on patients in primary care can significantly reduce pain and the need for surgery.