<<Miscellaneous:Practice Letterhead>>

GP MANAGEMENT PLAN - MBS ITEM 721 (OSTEOARTHRITIS)

Patient’s Name: <<Patient Demographics:Full Name>> | Date of Birth: <<Patient Demographics:DOB>>

Contact Details: | Medicare or Private Health Insurance Details:

<<Patient Demographics:Full Address>>

<<Patient Demographics:Medicare Number>>
<<Patient Demographics:Health Insurance>>

Details of Patient’s Usual GP: | Details of Patient’s Carer (if applicable):

<<Doctor:Name>>
<<Doctor:Full Address>>

Date of last Care Plan/GP Management Plan (if done):  <<Date of last Care Plan/GPMP>>

Other notes or comments relevant to the patient’s care planning: 

PAST MEDICAL HISTORY

<<Clinical Details:History List>>

FAMILY HISTORY

<<Clinical Details:Family History>>

MEDICATIONS 

<<Clinical Details:Medication List>>

ALLERGIES

Patient’s Name: <<Patient Demographics:Full Name>>

GP MANAGEMENT PLAN - MBS ITEM 721 (OSTEOARTHRITIS)

Patient problems / needs / relevant conditions | Goals - changes to be achieved | Required treatments and services including patient actions | Arrangements for treatments/services (when, who, contact details)
1. General | | |

Patient's understanding of osteoarthritis

Patient to have a clear understanding of osteoarthritis and the patient's role in self management

Patient education

GP
Patient

Pain management

Optimal pain management

Development of pain management program suitable to needs of patient

GP/nurse
Patient

2. Lifestyle | | |

Weight

Your target: BMI < __  
Ideal: BMI ≤ 25 kg/m^2

Monitor
Review 6 monthly

OR 
As per Lifescripts action plan

Patient to monitor
GP/nurse to review
Dietician

Physical activity

Maintain physical activity
Your target:
  
Ideal:
Exercise at least 30 minutes walking or equivalent 5 or more days per week

Patient exercise routine
Functional aids

OR 
As per Lifescripts action plan

GP
Physiotherapist
Exercise physiologist
Patient to implement

Mobility

Optimise / preserve mobility

Patient aids / home modification
Review of footwear / need for orthoses

GP
Occupational therapist
Podiatrist

3. Medication | | |

Medication review

Correct use of medications, minimise side effects

Patient education
Review medications
Options to be considered
- topical agents
- simple analgesia
- NSAIDS
- Cox-2 inhibitors
- Tramadol
- Opioid analgesia

GP to review and provide education

4. Complementary /alternative therapy | | |

Complementary / alternative therapy

Review use of complementary medicine

Options to be considered
- glucosamine
- chondroitin sulfate
- acupuncture
- tai chi

GP

5. Further Treatment | | |

Joint specific problems

Minimise joint specific problems

Joint specific therapy.  Options to be considered:
- Intra-articular cortico-steroid injections
- Intra-articular hyaluronan injections

GP
Rheumatologist
Orthopaedic surgeon

Need for surgical intervention

Reduce pain / increase mobility

Consider options for surgical intervention

GP
Rheumatologist
Orthopaedic surgeon

6. Psychosocial | | |
Depression | Ensure mental well-being | Management of psychological disease burden | GP to advise and refer

Assistance with daily living activities

Optimise / preserve independence

Assistance in the home / other.
Referral to support group

GP to advise and monitor
Support services

Copy of GP Management Plan offered to patient?  <<Copy of GPMP offered to patient?>>

Copy / relevant parts of the GP Management Plan supplied to other providers?  <<Copy of GPMP supplied to other providers?>>

GP Management Plan added to the patient’s records?  <<GPMP added to patient's records?>>

Date service was completed:  <<Date service completed>> | Proposed Review Date:  <<Proposed review date (recommended 6 months)>>

I have explained the steps and any costs involved, and the patient has agreed to proceed with the plan.  <<Steps and costs explained, patient agreed>>

 GP’s Signature:  ________________________________________________	Date:___________________

Original template compiled by Monash Division of General Practice, March 2006