Well, its finally here -- the @ArthritisFdn / @ACRheum guidelines for hand hip and knee OA, now with patient perspectives, courtesy of the Arthritis Foundation Live Yes! Arthritis Network!

Patient engagement consisted of a primary patient panel of @ArthritisFdn Live Yes! Network pts who had received interventions under review in the guidelines. Importantly, delegates of that panel also participated in voting and manuscript prep.

Several participants also participated in the new treatments risk benefit assessment organizated by the @ArthritisFdn through the @US_FDA externally led patient focused drug development program

Strong recommendations for excercise (aeorbic, strengthening, neuromuscular. And aquatic). Weightloss for (hip, knee) 5-10%

Strong recommendations for self efficacy and self management including support from peers.

Also strong tai chi rec, as well as cane use when used correctly and braces

But TENS is not recemmended.

Conditional recs for accupuncture, and some braces. Thernal interventions.

Against massage.

Changes between old guidelines and the new guidelines presented at #ACR2019

Patient panel acknowledged as being very concerned about a specialty society broadly striking opioids. Patients dont want opioids, but dont want barriers if they are contraindicated for other pain relief. Panel distinguished between tramadol opioids over less preferred opioids