arthritis: the disease, the program & interventions debbie campbell mba, ches arthritis health...
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Arthritis: The Disease, Arthritis: The Disease, The Program & The Program & InterventionsInterventions
Debbie Campbell MBA, CHESDebbie Campbell MBA, CHESArthritis Health Section ChiefArthritis Health Section Chief
Department of Health & Human Services - Division of HealthDepartment of Health & Human Services - Division of Health
andand
Appathurai Balamurugan MD, MPH Appathurai Balamurugan MD, MPH Senior Epidemiologist, Senior Epidemiologist,
Department of Health & Human Services - Division of Health Department of Health & Human Services - Division of Health Assistant Professor, Dept. of Epidemiology, UAMS College of Public Assistant Professor, Dept. of Epidemiology, UAMS College of Public
Health Health
Debbie Campbell MBA, CHESDebbie Campbell MBA, CHESArthritis Health Section ChiefArthritis Health Section Chief
Department of Health & Human Services - Division of HealthDepartment of Health & Human Services - Division of Health
andand
Appathurai Balamurugan MD, MPH Appathurai Balamurugan MD, MPH Senior Epidemiologist, Senior Epidemiologist,
Department of Health & Human Services - Division of Health Department of Health & Human Services - Division of Health Assistant Professor, Dept. of Epidemiology, UAMS College of Public Assistant Professor, Dept. of Epidemiology, UAMS College of Public
Health Health
The “Arthritis” StoryThe “Arthritis” StoryThe “Arthritis” StoryThe “Arthritis” Story
70 million Americans 70 million Americans Leading cause of disability among Leading cause of disability among
Americans over age 15Americans over age 15 Affects nearly 300,000 children Affects nearly 300,000 children Baby boomers are now at prime Baby boomers are now at prime
risk, as more than half those risk, as more than half those affected are under age 65affected are under age 65
70 million Americans 70 million Americans Leading cause of disability among Leading cause of disability among
Americans over age 15Americans over age 15 Affects nearly 300,000 children Affects nearly 300,000 children Baby boomers are now at prime Baby boomers are now at prime
risk, as more than half those risk, as more than half those affected are under age 65affected are under age 65
The “Arthritis” Story The “Arthritis” Story Cont.Cont.
Second only to heart disease as a Second only to heart disease as a cause of work disabilitycause of work disability
39 million physician visits every 39 million physician visits every yearyear
More than a half million More than a half million hospitalizations per year hospitalizations per year
$86.2 billion annually $86.2 billion annually
Second only to heart disease as a Second only to heart disease as a cause of work disabilitycause of work disability
39 million physician visits every 39 million physician visits every yearyear
More than a half million More than a half million hospitalizations per year hospitalizations per year
$86.2 billion annually $86.2 billion annually
OutlineOutline
Arthritis – Economic & Disease Arthritis – Economic & Disease
BurdenBurden
Arthritis Health ProgramArthritis Health Program
Arthritis ManagementArthritis Management
Arthritis – Economic & Disease Arthritis – Economic & Disease
BurdenBurden
Arthritis Health ProgramArthritis Health Program
Arthritis ManagementArthritis Management
Arthritis is an Arthritis is an umbrellaumbrella termterm
Rheumatoid Arthritis
Rheumatoid Arthritis
FibromyalgiaFibromyalgia
GoutGout Lyme DiseaseLyme Disease
BursitisBursitis
LupusLupus
Juvenile ArthritisJuvenile Arthritis
Ankylosing SpondylitisAnkylosing Spondylitis
OsteoarthritisOsteoarthritis
Figure 1. An estimated 1 million Arkansans have Arthritis
619,000
990,000
319,000
DiagnosedPossibleNo arthritis
* Source: BRFSS, 2004
Figure 2. Arthritis Prevalence in Arkansas and US *, 2003
27%32%
0%
10%
20%
30%
40%
50%
US Arkansas
Per
cen
tage
of
pop
ula
tion
* Source: BRFSS, 2003
Per
cen
tag
e o
f P
op
ula
tio
n
Figure 3. Trends in Arthritis Prevalence in Arkansas *, 2002-2004
33% 32% 32%
0%
10%
20%
30%
40%
50%
2002 2003 2004
Year
Perc
en
tag
e o
f p
op
ula
tio
n
* Source: BRFSS
Pe
rce
nta
ge
of
Po
pu
lati
on
Figure 4. Percentage of Adults with Arthritis,* 2003
* People 18 or older with self-reported, doctor-diagnosed arthritis. Source: CDC, Behavioral Risk Factor Surveillance System, 2003
Figure 5. Arthritis Prevalence In Arkansas By Age Figure 5. Arthritis Prevalence In Arkansas By Age Categories, 2004Categories, 2004
16%
41%56%
0%
20%
40%
60%
80%
100%
18-44 45-64 65+
Age groups* Source: BRFSS, 2004
Perc
en
tag
e w
ith
A
rth
riti
s
Figure 6. Arthritis Prevalence in Arkansas by gender, Figure 6. Arthritis Prevalence in Arkansas by gender, 20042004
28%36%
0%
20%
40%
60%
80%
100%
Male Female
* Source: BRFSS, 2004
Perc
en
tag
e w
ith
A
rth
riti
s
Figure 7. Arthritis Prevalence in Arkansas by race, Figure 7. Arthritis Prevalence in Arkansas by race, 20042004
32% 29%23%
31%
0%
20%
40%
60%
80%
100%
Race
White Black Hispanic Other
Pe
rce
nta
ge
wit
h A
rth
riti
s
Arthritis Prevalence in Arkansas, 2002 Arthritis Prevalence in Arkansas, 2002
Prevalence of Doctor- Diagnosed Arthritis*
24.6 – 29.9%
█ 30.0 – 34.9%
█ 35.0 – 39.9%
█ 40.0 – 48.6%* BRFSS 2002
Cost Due to Arthritis and Related Cost Due to Arthritis and Related ConditionsConditions
Cost Due to Arthritis and Related Cost Due to Arthritis and Related ConditionsConditions
Figure 8. Total* Cost Attributable to Arthritis and Other Rheumatic Conditions, Using Selected Categories, 50 States and D.C., U.S., 1997
Figure 8. Total* Cost Attributable to Arthritis and Other Rheumatic Conditions, Using Selected Categories, 50 States and D.C., U.S., 1997
* Total = direct (costs attributable to medical expenditures) + indirect (costs attributable to work loss)
Source: CDC Arthritis Program
$2.2 – $8.4 billion$1.5 - $2.2 billion
$750 million - $1.3 billion$121 million - $578 million
Direct Healthcare Expenses Due to Direct Healthcare Expenses Due to ArthritisArthritis
Site of ServiceSite of Service Costs Costs RankRank
Home Healthcare $ 2.49 B 1Home Healthcare $ 2.49 B 1
Ambulatory care $ 7.93 B 2Ambulatory care $ 7.93 B 2
In-patient $ 5.70 B 4In-patient $ 5.70 B 4
Prescription Meds $ 5.15 B 5Prescription Meds $ 5.15 B 5
Site of ServiceSite of Service Costs Costs RankRank
Home Healthcare $ 2.49 B 1Home Healthcare $ 2.49 B 1
Ambulatory care $ 7.93 B 2Ambulatory care $ 7.93 B 2
In-patient $ 5.70 B 4In-patient $ 5.70 B 4
Prescription Meds $ 5.15 B 5Prescription Meds $ 5.15 B 5
Source: Healthcare Spending and Use Among United State Community-Dwelling Adults for the 20 most costly conditionsSource: Healthcare Spending and Use Among United State Community-Dwelling Adults for the 20 most costly conditions
Direct Healthcare Expenses Due Direct Healthcare Expenses Due to Arthritis by Source of to Arthritis by Source of
PaymentPayment
Direct Healthcare Expenses Due Direct Healthcare Expenses Due to Arthritis by Source of to Arthritis by Source of
PaymentPayment
7.616.49
2.653.48
0
2
4
6
8
10
PrivateInsurance
Medicare Medicaid Self-pay
$
Bil
lion
s of
dol
lars
Source: Healthcare Spending and Use Among United State Community-Dwelling Adults for the 20 most costly conditionsSource: Healthcare Spending and Use Among United State Community-Dwelling Adults for the 20 most costly conditions
$ B
illion
s o
f d
ollars
Figure 9. Hospital Discharges with Primary Diagnosis of Arthritis, Arkansas
2002-2004
10010 10607 11518
0
5000
10000
15000
2002 2003 2004Year
Nu
mb
er o
f H
osp
ital
Dis
char
ges
Nu
mb
er o
f H
osp
ital
Dis
char
ges
Figure 11. Total Hospitalization Charges Due to Arthritis, Arkansas, 2002-2004
$197$230
$272
0
100
200
300
2002 2003 2004
Mil
lio
ns
of
Do
llar
s ($
)M
illi
on
s o
f D
oll
ars
($)
Year
Figure 12. Average Charges for Hospitalizations due to Arthritis, Arkansas,
2002-2004
$19,703$21,721
$23,650
0
5000
10000
15000
20000
25000
2002 2003 2004
Th
ou
sa
nd
s o
f D
olla
rsT
ho
us
an
ds
of
Do
llars
Osteoarthritis (OA)Osteoarthritis (OA)
Clinical Clinical presentationpresentation
EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Clinical Clinical presentationpresentation
EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Figure 13. Hospital Discharges with Primary Diagnosis of Osteoarthritis, Arkansas 2002-2004
52855924
6657
0
2000
4000
6000
8000
2002 2003 2004
Nu
mb
er
of
Ho
spit
al D
isch
arg
es
Nu
mb
er
of
Ho
spit
al D
isch
arg
es
Figure 14. Total Hospitalization Charges Due to Osteoarthritis, Arkansas, 2002-2004
$119$146
$174
0
50
100
150
200
2002 2003 2004
Mil
lio
ns
of
Do
llar
s ($
)M
illi
on
s o
f D
oll
ars
($)
Year
Rheumatoid Arthritis Rheumatoid Arthritis (RA)(RA)
Rheumatoid Arthritis Rheumatoid Arthritis (RA)(RA)
Clinical Clinical presentationpresentation
EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Clinical Clinical presentationpresentation
EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Figure 15. Hospital Discharges with Primary Diagnosis of Rheumatoid Arthritis, Arkansas
2002-2004266 253
223
0
100
200
300
2002 2003 2004
Nu
mb
er
of
Ho
spit
al D
isch
arg
es
Nu
mb
er
of
Ho
spit
al D
isch
arg
es
Year
Figure 16. Total Hospitalization Charges Due to Rheumatoid Arthritis, Arkansas,
2002-2004
$4.1 $4.3 $4.4
0
2
4
6
8
2002 2003 2004
Mill
ion
s o
f D
olla
rs (
$)
Mill
ion
s o
f D
olla
rs (
$)
Year
Systemic Lupus Erythematosus Systemic Lupus Erythematosus (SLE)(SLE)
Clinical Clinical presentationpresentation
EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Figure 17. Hospital Discharges with Primary Diagnosis of Systemic Lupus Erythematosus,
Arkansas 2002-2004
131106
143
0
100
200
300
2002 2003 2004
Nu
mb
er
of
Ho
spit
al D
isch
arg
es
Nu
mb
er
of
Ho
spit
al D
isch
arg
es
Year
Figure 18. Total Hospitalization Charges Due to Systemic Lupus Erythematosus, Arkansas,
2002-2004
$1.8 $1.7
$3.9
0
2
4
6
8
2002 2003 2004
Mill
ion
s o
f D
olla
rs (
$)
Mill
ion
s o
f D
olla
rs (
$)
Year
GoutGout
Clinical Clinical presentationpresentation
EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Figure 19. Hospital Discharges with Primary Diagnosis of Gout, Arkansas 2002-2004
123
96109
0
50
100
150
200
2002 2003 2004
Nu
mb
er
of
Ho
spit
al D
isch
arg
es
Nu
mb
er
of
Ho
spit
al D
isch
arg
es
Year
Figure 20. Total Hospitalization Charges Due to Gout, Arkansas, 2002-2004
$0.9
$0.6
$1.0
0
1
1
2
2002 2003 2004
Mill
ion
s o
f D
olla
rs (
$)
Mill
ion
s o
f D
olla
rs (
$)
Year
FibromyalgiaFibromyalgia
Clinical Clinical presentationpresentation
EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Back PainBack Pain
Clinical presentationClinical presentation EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Infectious ArthritisInfectious Arthritis
• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment
• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment
Occupational & Sports Related Occupational & Sports Related Injuries Causing ArthritisInjuries Causing Arthritis
Clinical presentationClinical presentation
Occupational – CTSOccupational – CTS
Sports – Tennis ElbowSports – Tennis Elbow EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Clinical presentationClinical presentation
Occupational – CTSOccupational – CTS
Sports – Tennis ElbowSports – Tennis Elbow EpidemiologyEpidemiology DiagnosisDiagnosis TreatmentTreatment
Juvenile ArthritisJuvenile Arthritis
• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment
• Clinical presentation
• Epidemiology
• Diagnosis
• Treatment
Health Status Health Status Among Among
People With ArthritisPeople With Arthritis
Arthritis is the No. 1 cause of disability in the US and in AR
Figure 21. Health status* among people with arthritisFigure 21. Health status* among people with arthritisFigure 21. Health status* among people with arthritisFigure 21. Health status* among people with arthritis
63%
37%
Excellent/Good Health Fair/Poor Health
* Source: BRFSS, 2004
Figure 22. Health status among people with arthritis
67%
33%
0%
20%
40%
60%
80%
100%
Can doeverything/most
things
Can dosomethings/hardly
anything
* Source: BRFSS, 2004
Pe
rce
nta
ge
Pe
rce
nta
ge
Risk FactorsRisk Factors&&
Preventive Care Preventive Care ServicesServices
Figure 23. Role of Body weight in Figure 23. Role of Body weight in ArthritisArthritis
2%
36%
32% 31%
underweight normal overweight obese
* Source: BRFSS, 2004
Figure 24. Role of Physical Activity Figure 24. Role of Physical Activity in Arthritisin Arthritis
40%
37%
23%
Physically active Insufficient activity Inactive
* Source: BRFSS, 2003
Figure 25. Preventive care practices among people with Arthritis, 2004
13%
53%
28%
0% 20% 40% 60% 80%
Ever taken an arthritis self-help course
Advised by Doctor to be involved in PAor exercise for Arthritis
Advised by Doctor to lose weight forarthritis
Percentage of persons with arthritis* Source: BRFSS, 2004
ARARthritis thritis Health ProgramHealth Program
MissionMissionMissionMission
““Reduce the Impact of Reduce the Impact of Arthritis and other Arthritis and other
Rheumatic Conditions” Rheumatic Conditions” among Arkansansamong Arkansans
““Reduce the Impact of Reduce the Impact of Arthritis and other Arthritis and other
Rheumatic Conditions” Rheumatic Conditions” among Arkansansamong Arkansans
GoalsGoals Increase Awareness and Increase Awareness and
KnowledgeKnowledge Expand Evidence-based Expand Evidence-based
InterventionsInterventions Establish and Maintain Establish and Maintain
PartnershipsPartnerships Expand and Maintain Expand and Maintain
SurveillanceSurveillance
InterventionsInterventions(No Longer Sitting Still for the Pain)(No Longer Sitting Still for the Pain)
Health Communication Health Communication CampaignCampaign
Evidence-Based Programs Evidence-Based Programs
““Physical Activity. The Arthritis Pain Physical Activity. The Arthritis Pain Reliever”Reliever”
Physical Activity and Physical Activity and ArthritisArthritis
Pain ReliefPain Relief
Improved Joint FunctionImproved Joint Function
Improved Well-beingImproved Well-being
Overall Health BenefitsOverall Health Benefits
Reduced DisabilityReduced Disability
Weight LossWeight Loss
Physical Activity
Benefits of Exercising With Benefits of Exercising With ArthritisArthritis
Benefits of Exercising With Benefits of Exercising With ArthritisArthritis
Joint flexibility & mobilityJoint flexibility & mobility Nourishes cartilageNourishes cartilage Muscle strengthMuscle strength Cardiovascular fitness, circulationCardiovascular fitness, circulation Weight control, better appearanceWeight control, better appearance Sense of well-being, less stress & Sense of well-being, less stress &
depressiondepression
Joint flexibility & mobilityJoint flexibility & mobility Nourishes cartilageNourishes cartilage Muscle strengthMuscle strength Cardiovascular fitness, circulationCardiovascular fitness, circulation Weight control, better appearanceWeight control, better appearance Sense of well-being, less stress & Sense of well-being, less stress &
depressiondepression
Benefits of Exercising With Benefits of Exercising With Arthritis Cont.Arthritis Cont.
Benefits of Exercising With Benefits of Exercising With Arthritis Cont.Arthritis Cont.
Bone strengthBone strength Endurance, stamina, Endurance, stamina,
more energymore energy Function, ability to Function, ability to
perform daily activitiesperform daily activities Posture, balance & Posture, balance &
coordinationcoordination Regular bowel habitsRegular bowel habits Quality of sleepQuality of sleep
Bone strengthBone strength Endurance, stamina, Endurance, stamina,
more energymore energy Function, ability to Function, ability to
perform daily activitiesperform daily activities Posture, balance & Posture, balance &
coordinationcoordination Regular bowel habitsRegular bowel habits Quality of sleepQuality of sleep
1. Arthritis Foundation Aquatic Program
1. Arthritis Foundation Aquatic Program
Aquatics Classes In Arkansas CountiesAquatics Classes In Arkansas Counties
* Aquatics classes
Source: Arthritis Foundation, 6/8/2005
2. Arthritis Foundation Exercise 2. Arthritis Foundation Exercise ProgramProgram
2. Arthritis Foundation Exercise 2. Arthritis Foundation Exercise ProgramProgram
PACE Classes In Arkansas CountiesPACE Classes In Arkansas Counties
@ PACE classes
Source: Arthritis Foundation, 6/8/2005
3. Arthritis Foundation Self–Help Program:3. Arthritis Foundation Self–Help Program:Take Control With KnowledgeTake Control With Knowledge
3. Arthritis Foundation Self–Help Program:3. Arthritis Foundation Self–Help Program:Take Control With KnowledgeTake Control With Knowledge
ASHC WORKSHOP OVERVIEW ASHC WORKSHOP OVERVIEW
TOPICSTOPICS WeeWeek k OneOne
WeeWeek k TwoTwo
Week Week ThreeThree
WeeWeek k FourFour
WeeWeek k FiveFive
WeeWeek Sixk Six
1. Self-Management 1. Self-Management PrinciplesPrinciples
√√
2. Pain-Management 2. Pain-Management PrinciplesPrinciples
√√
3. Cognitive Pain 3. Cognitive Pain ManagementManagement
√√ √√ √√ √√
4. Goal-Setting/Action Plans4. Goal-Setting/Action Plans √√ √√ √√ √√ √√ √√
5. Problem-Solving Steps 5. Problem-Solving Steps √√
6. Exercise/Fitness6. Exercise/Fitness √√ √√ √√
7. Feedback/Problem-Solving 7. Feedback/Problem-Solving √√ √√ √√ √√ √√
3. Arthritis Foundation Self–Help Program:3. Arthritis Foundation Self–Help Program:Take Control With KnowledgeTake Control With Knowledge
3. Arthritis Foundation Self–Help Program:3. Arthritis Foundation Self–Help Program:Take Control With KnowledgeTake Control With Knowledge
ASHC WORKSHOP OVERVIEW ASHC WORKSHOP OVERVIEW
TOPICSTOPICS WeeWeek k OneOne
WeeWeek k TwoTwo
Week Week ThreeThree
WeeWeek k FourFour
WeeWeek k FiveFive
WeeWeek Sixk Six
8. Difficult Emotions8. Difficult Emotions √√
9. Healthy Eating9. Healthy Eating √√
10. Osteoporosis10. Osteoporosis √√
11. Fatigue and Energy 11. Fatigue and Energy
ConservationConservation√√
12. Medication Usage12. Medication Usage √√
13. Depression13. Depression √√
14. Working with Health Care 14. Working with Health Care
ProvidersProviders√√
15. Evaluating Treatments15. Evaluating Treatments √√
16. Sleep16. Sleep √√
Support GroupsSupport GroupsSupport GroupsSupport Groups
Arthritis Support GroupArthritis Support Group
Lupus Support GroupLupus Support Group
Fibromyalgia Support Group Fibromyalgia Support Group
Arthritis Support GroupArthritis Support Group
Lupus Support GroupLupus Support Group
Fibromyalgia Support Group Fibromyalgia Support Group
Support Groups In Arkansas CountiesSupport Groups In Arkansas Counties
*Arthritis support group
# Fibromyalgia support group
@ Lupus support group
Source: Arthritis Foundation, 6/8/2005
Arthritis Arthritis ManagemeManageme
ntnt
10 Signs Of An Unproven 10 Signs Of An Unproven Arthritis RemedyArthritis Remedy
10 Signs Of An Unproven 10 Signs Of An Unproven Arthritis RemedyArthritis Remedy
10. The 10. The "Conspiracy Theory""Conspiracy Theory"
9. It's a 9. It's a "Special Diet ""Special Diet "
8. It's 8. It's "Untested “"Untested “
7. Drugs and Surgery are 7. Drugs and Surgery are
"Condemned""Condemned"
6. The Body is 6. The Body is "Cleansed""Cleansed"
10. The 10. The "Conspiracy Theory""Conspiracy Theory"
9. It's a 9. It's a "Special Diet ""Special Diet "
8. It's 8. It's "Untested “"Untested “
7. Drugs and Surgery are 7. Drugs and Surgery are
"Condemned""Condemned"
6. The Body is 6. The Body is "Cleansed""Cleansed"
10 Signs Of An Unproven 10 Signs Of An Unproven Arthritis RemedyArthritis Remedy Cont. Cont.
10 Signs Of An Unproven 10 Signs Of An Unproven Arthritis RemedyArthritis Remedy Cont. Cont.
5. It's 5. It's "Quick or Simple""Quick or Simple"
4. Advertising is 4. Advertising is "Sensationalized""Sensationalized"
3. The 3. The "Testimonial""Testimonial"
2. It's a 2. It's a "Secret""Secret"
1. It's a 1. It's a "Cure" "Cure"
5. It's 5. It's "Quick or Simple""Quick or Simple"
4. Advertising is 4. Advertising is "Sensationalized""Sensationalized"
3. The 3. The "Testimonial""Testimonial"
2. It's a 2. It's a "Secret""Secret"
1. It's a 1. It's a "Cure" "Cure"
Arthritis TreatmentArthritis TreatmentArthritis TreatmentArthritis Treatment
Medical management – Medical management – Analgesics, Analgesics, NSAIDs, DMARDs, Biologic NSAIDs, DMARDs, Biologic response modifiers, Corticosteriodresponse modifiers, Corticosteriod
Surgery – Traction, Joint or Surgery – Traction, Joint or Disc replacement, Laser, Disc replacement, Laser, endoscopyendoscopy
Medical management – Medical management – Analgesics, Analgesics, NSAIDs, DMARDs, Biologic NSAIDs, DMARDs, Biologic response modifiers, Corticosteriodresponse modifiers, Corticosteriod
Surgery – Traction, Joint or Surgery – Traction, Joint or Disc replacement, Laser, Disc replacement, Laser, endoscopyendoscopy
Alternative Treatment for Alternative Treatment for ArthritisArthritis
Alternative Treatment for Alternative Treatment for ArthritisArthritis
Hot Springs, Arkansas
Hot Springs, Arkansas
Alternative Treatment for Alternative Treatment for Arthritis Cont.Arthritis Cont.
AcupunctureAcupuncture AyurvedaAyurveda BiofeedbackBiofeedback ChiropracticChiropractic Chondroitin sulfateChondroitin sulfate Copper braceletCopper bracelet Chinese HerbsChinese Herbs Diet & Diet &
SupplementsSupplements Fish oilFish oil
AcupunctureAcupuncture AyurvedaAyurveda BiofeedbackBiofeedback ChiropracticChiropractic Chondroitin sulfateChondroitin sulfate Copper braceletCopper bracelet Chinese HerbsChinese Herbs Diet & Diet &
SupplementsSupplements Fish oilFish oil
Green tea Green tea
HomeopathyHomeopathy
HydrotherapyHydrotherapy
MassageMassage
MeditationMeditation
Tai ChiTai Chi
YogaYoga
Green tea Green tea
HomeopathyHomeopathy
HydrotherapyHydrotherapy
MassageMassage
MeditationMeditation
Tai ChiTai Chi
YogaYoga
Recent Advances in Arthritis Recent Advances in Arthritis ManagementManagement
Newer Drugs – abatacept, Rituximab, Newer Drugs – abatacept, Rituximab, FebuxostatFebuxostat
Medicare Part D prescription drug Medicare Part D prescription drug planplan
Research findings – Weight loss and Research findings – Weight loss and ExerciseExercise
FDA decision on COX-2 selective FDA decision on COX-2 selective inhibitor drugsinhibitor drugs
Genetic researchGenetic research
Newer Drugs – abatacept, Rituximab, Newer Drugs – abatacept, Rituximab, FebuxostatFebuxostat
Medicare Part D prescription drug Medicare Part D prescription drug planplan
Research findings – Weight loss and Research findings – Weight loss and ExerciseExercise
FDA decision on COX-2 selective FDA decision on COX-2 selective inhibitor drugsinhibitor drugs
Genetic researchGenetic research
CDC RecommendationsCDC Recommendations
See Your DoctorSee Your Doctor
Learn What You Can DoLearn What You Can Do
Be ActiveBe Active
Watch Your WeightWatch Your Weight
Protect Your JointsProtect Your Joints
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