Shedding light on osteoarthritis: A chronic condition that cannot be ignored

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Dr. Gillian Hawker
Women's College Hospital
University of Toronto

Although osteoarthritis (OA) is the most common form of arthritis affecting about 1 in 10 Canadians, it is a condition that is not receiving a whole lot of attention, which is what prompted Dr. Gillian Hawker to pursue OA as her main area of investigation.

Dr. Hawker was headed for a career in hematology/oncology but switched to rheumatology. She was drawn to its 'whole patient' perspective as rheumatologic conditions can affect virtually all the organ systems. She is currently a Professor of Medicine and Rheumatology in the Departments of Medicine and Health Policy, Management and Evaluation at the University of Toronto, the physician-in-chief of the department of medicine at Women's College Hospital and the director of the Canadian Osteoarthritis Research Program.

Dr. Hawker's research focuses on two main areas related to OA. First, the disparities in rates of use of total joint replacement surgery for OA by gender/socioeconomic status/geography, why these disparities exist, and what we can do to reduce them; second, understanding the determinants and consequences of pain in OA, including the downstream effects of OA pain on fatigue, disability, sleep and mood.

For their research, Dr. Hawker and her team have been following a cohort of people living with hip and knee OA for more than 15 years now. The team involves their OA consumers through an advisory group and they have held lunches for their cohort participants to tell them about results at the end of each phase of research. Currently, they are exploring the impact of OA on management of other common conditions like diabetes and heart disease – hoping to bring some additional attention to OA as an important chronic condition that cannot be ignored.

When asked about her work as chief of medicine of Women's College Hospital in Toronto, Dr. Hawker says that she spends a lot of time developing programs to address and prevent hospitalization in people with complex chronic conditions.

"Approximately 1% of the population of Ontario accounts for about half of the hospital and homecare costs to the province – most of these people have multiple medical conditions, notably heart disease, diabetes, depression and yes…MSK conditions, mainly OA!"

She hopes to focus future research on treatment guidelines for patients with OA and other health problems, like heart disease or diabetes. Research to date shows that OA is under-treated in part due to the high frequency of these other conditions, which both doctors and patients often perceive as contra-indications to the use of OA pain therapies, e.g. non-steroidal anti-inflammatory (NSAID) drugs.