Joint Support Magazine Autumn 2023

Improving the life of every person affected by arthritis

JOINT SUPPORT

Exercise-based models of care are likely to produce significant qualityof-life impacts

Exercise-based models of care are likely to produce significant qualityof-life impacts

See page 3

Improving services for people with osteoarthritis

By Francesca Holloway

Osteoarthritis (OA) is the most prevalent form of arthritis in this country, with over 400,000 people affected. This number is expected to increase as the population ages. We know that often clients are told they have arthritis, they need to learn to live with it, and to come back when they cannot walk. A group of researchers, academics and health professionals are working to improve services for people with OA, emphasising developing a National Osteoarthritis Strategy that provides a range of options for consumers.

The inaugural New Zealand Osteoarthritis Summit ǀ Taumata Kaikōiwi Aotearoa was held in Wellington late last year to look at how we can improve the management of OA in New Zealand. The opening address was from Dr Andrew Connelly, Counties Manukau Chief Medical Officer and Chair of the government-appointed Planned Care Taskforce, which focused on looking at how waiting lists can be better managed. He highlighted that one of the challenges in doing this is to ensure nationally consistent criteria for prioritising placement on waiting lists. He also emphasised the importance of knowing the overall needs so there can be equitable management of resources and provision of care across regions. World OA expert Professor David Hunter of the University of Sydney/

Royal North Shore Hospital shared lessons from the Australian development of a model of care for OA. He emphasised that one of the keys to developing good OA care is strong linkages between health professionals, consumers, and advocacy organisations. This inclusivity has been pivotal.

Philip Kearney, CEO of Arthritis NZ, spoke on the NZIER report on the case for investment in nonsurgical guideline-informed models of care for OA of the hip and knee (see p.3) and Timi Tapara, Director/ Founder of Tū Tonu Health Centre in Hamilton, shared his inspiring and deeply personal journey relating to past OA injury as an aspiring rugby player. Dr Richard Griffiths, Research Manager at Arthritis NZ, addressed the significance of the consumer voice and the central role that consumers with OA will play in work being done to produce a National Osteoarthritis Strategy. His presentation featured video clips from people with OA who are part of Arthritis NZ’s Consumer Reference Group. They shared their lived experience of OA and provided an essential consumer voice.

If you would like to join our Consumer Reference Group call us on 0800663463 and ask to speak to Tory - she will be delighted to hear from you.

More details about the 2022 OA Summit can be viewed on the Arthritis NZ website: www.arthritis. org.nz/osteoarthritis-aotearoa-new-zealand/

Exercise-based models of care likely to produce significant quality-of-life impacts

Report by NZIER

Evidence for non-surgical, nonpharmacologic models of care in hip and knee Osteoarthritis (OA).

There are more than 408,000 New Zealanders who have osteoarthritis (OA). This form of arthritis is the most prevalent among people with arthritis, costing the health system a staggering $990 million annually. Direct productivity costs are $1.2 billion per year, and informal caregiver productivity costs $1.5 billion per year. These economic costs and the evidence for non-surgical, non-pharmacologic models of care in hip and knee OA spurred Arthritis NZ to commission the New Zealand Institute of Economic Research (NZIER) to identify the most robust recent economic evidence on nonsurgical, guidelineinformed models of care for OA of the hip and/or knee involving education and self-management, education and exercise, and exercise with or without manual therapy

The evidence presents some clear signals about costeffective models of care. The assessment indicates that achieving a favourable return on investment (ROI) from non-surgical, non-pharmacologic models of care is possible.

The MOA: Management of Osteoarthritis programme exercise model trialled in New Zealand proves this as it demonstrated health system savings and significant quality of life impacts.

Successful models of care for OA reduce GP visits, specialist visits and medication costs and help address unmet needs and avoid or delay surgery, reducing pressure on the system. The New Zealand Joint Clinic programme demonstrated these impacts. Participation in the Mobility Action Programme

(MAP) had high representation from Māori and Pacific People. It significantly improved confidence to self-manage their conditions and substantially reduced visits to GPs, specialists, and other secondary health services. The MAP was projected to be cost-effective over a 5-year time horizon. Exercise-based models of care appear to be the most likely to generate health system savings. Nonsurgical, non-pharmacologic models of care for OA often offer functional improvements over conventional care, resulting in productivity and quality of life gains that mean the societal ROI is even greater than the health system’s ROI. The highest ROI of all models reviewed was for the MOA exercise model of care, associated with a societal return on investment of $13.52 per dollar invested.

Key highlights: These models of care can support the health system in achieving its goals. The health system reforms envisage a scenario where “everyone can access a wider range of support to stay well in the community, with more services designed around people’s needs and which better support self-care”, as well as more equitable access and outcomes. The findings by NZIER indicate that alternative models of care for OA can offer improved health outcomes at no additional cost to the health budget as well as being equity-enhancing due to the high costs of OA that patients currently bear through privately funded care and productivity losses, both of which people on low incomes cannot afford.

NZIER recommends improved access to exercisebased interventions (with additional core treatments such as weight management as appropriate) in the community for people with OA, and the use of a triage provider model to improve access to OA care, reduce pressure on the health system, and support a more patient-centred approach to OA.

Arthritis Staff Dr Richard Griffiths, Dr Valerie Milne, Tory Garnham and Philip Kearney at the OA Summit where the NZIER report was presented.

Inspiring young people with arthritis

By Georgie-Anne Cox

On 27 January we waited at Wellington Airport as 30 teens flew in from all over Aotearoa to join us for Teens Camp 2023. The previous two years have been cancelled due to the COVID-19 pandemic, so connecting in person felt extra special this year. Seeing these young adults have the courage and success in catching flights – some even connecting ones, was fantastic. Some lucky teens even got a quick photo and selfie in with the former Prime Minister, Jacinda Ardern, as she was spotted in the airport. Anticipation filled the air as more and more attendees arrived, and before we knew it, we were on the bus headed to camp.

We watched relationships strengthen as the night went on; hours flew by filled with laughter while our teen leaders took the camp attendees through team-building games. Guessing each other’s age – without words! Learning about each other’s hometowns and families, and a paper folding game which was much harder than it looked.

The weekend was spent exploring El Rancho camp, and enjoying the action-packed activities. We didn’t let the rain stop us as we headed to raft building and kayaking – I think most of us ended the morning quite wet! We played mini golf at the pool, rock

climbed, and battled in soft archery.

The educational session with nurse specialist Nicola Gray was a highlight too. Nicola said spending time with her young patients outside of a clinical setting was special. It was an opportunity to talk about issues that the youth leaders had highlighted during the co-design of the camp as important topics, such as transitioning into adult rheumatology care. Having our youth leaders answer questions allowed for open conversations, with lived experiences, advice, and support.

The theme for Teen Camp 2023 was Connection. The Youth Advisory Group wanted to offer a place for young people with arthritis to feel connected, make lifelong friends, and understand that they are not alone in living well with Arthritis.

Teens Camp would not be possible with out the generosity of our donors. Thank you

“Hosting Teens Camp is a fantastic opportunity for young people with arthritis to connect with others who share similar experiences in a safe and supportive environment. Young people may feel isolated or misunderstood by their peers so attending the camp helps them develop a sense of community and belonging, leading to improved mental health, self-esteem, empowerment, and quality of life. We do our best to host these camps each year because we recognise their significant impact on young people with arthritis. By creating a positive and supportive experience, we aim to inspire young people to become volunteers within Arthritis NZ. This will help build a strong foundation for engaging with and supporting the arthritis community in the future.”

– Teens Camp Co-ordinators

Supported by

Creating an impact

By Jasmine White

Since my diagnosis with Juvenile Idiopathic Arthritis (JIA) when I was 16, I have developed a passion for creating awareness and advocating about the prevalence of this condition in young people like myself. This passion, which stems from wanting to support other young people with the type of support I wish I had been given at the time of my diagnosis, gave me the drive to begin volunteering with Arthritis NZ in 2020. In August 2022, I was honoured to be offered the opportunity to participate in a three-month internship with Arthritis NZ.

During the internship, I carried out multiple oneon-one peer support meetings with children and parents and used my lived experience to normalise feelings of unease or distress when facing a new diagnosis. I also co-designed the annual Arthritis NZ Teens and Familie’s camps. I facilitated the Arthritis NZ Youth Advisory Group to review the

camp designs and co-led this group through the modification process.

I also co-led the Arthritis NZ Youth Advisory Group while we created a mental health journal that provides activities, guidance, and journaling space to support a young person through the emotional challenges of their diagnosis. The Journals contain insightful tips that members of the Youth Advisory Group provided from their lived experiences. In October 2022, I was honoured to represent this group and be highly recognised for this work when I was nominated for and was successful in receiving multiple 2022 University of Canterbury Tohu Kahurangi Blues Awards. I was awarded Blue for Community Engagement, and I was the recipient of the Outstanding Contribution to Equity and Diversity for 2022.

“Jasmine’s involvement in youth services of Arthritis NZ has been invaluable. As a youth volunteer, she brings a fresh perspective, innovative ideas and a relatable presence to young people with arthritis. Jasmine’s willingness to share her journey with arthritis serves as a role model for others who may feel isolated or alone in their experiences.

Jasmine’s leadership skills with the youth group were significant in this year’s Teens Camp, her leadership during the camp helped ensure a positive experience for all involved. Overall having a volunteer like Jasmine engaged in youth services of Arthritis NZ provides numerous benefits, creating a stronger and more supportive community for all young people living with arthritis.”

– Tory Garnham, Arthritis NZ

Jasmine White

Arthritis and Heart Health

By Valerie Milne

Keeping our hearts healthy is essential for everybody, but even more so for people with arthritis. Information from the US shows that nearly half of all adults with heart disease also have arthritis. Australian research has found that 30.7% of middle-aged adults with arthritis and 70.4% of older adults with arthritis have at least one cardiovascular disease (CVD) risk factor.

The good news is that the changes you can make for living well with arthritis and taking medications to control inflammatory rheumatic diseases will work to keep your heart healthy. It is important for people who are told they have a form of arthritis and have not previously been assessed for heart disease risk to talk to their medical team (usually their GP) about medications for arthritis and how they might affect heart health.

Osteoarthritis

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their doctors. Allopurinol is an effective medicine for reducing gout attacks by reducing uric acid. It may also reduce the risk of heart disease; however, more research is required to confirm this. Keeping blood pressure and cholesterol levels low and reducing uric acid is important for managing health for people with gout arthritis. Some anti-inflammatory medications to reduce the pain of gout attacks may be harmful if you also have underlying CVD. Healthy eating and movement and keeping uric acid levels low are important to reduce the chance of gout arthritis flare-ups and are also important for keeping

Rheumatoid Arthritis and other autoimmune inflammatory arthritis

People with Osteoarthritis (OA) face a 24% higher risk of cardiovascular disease than the general population. Some medications to treat OA pain may not be suitable if a person has underlying high blood pressure or other heart disease risks. Keeping blood pressure and cholesterol levels low is an important part of managing health for people with OA. Discuss pain relief options and medications to reduce CVD risk with your GP. An OA healthy eating and movement plan to reduce the impact of osteoarthritis is also important for keeping your heart healthy.

Gout Arthritis

All patients with gout should have a CVD risk assessment. High uric acid levels are associated with increased cardiovascular risk. More than two out of every three people living with Gout Arthritis may have a very high risk of CVD, mainly hardening of the arteries, which can lead to heart attacks and stroke. It is very important for people diagnosed with gout arthritis to discuss the risk of heart disease with

While Rheumatoid Arthritis (RA) and other autoimmune inflammatory arthritis are primarily joint diseases, they can affect other body parts, including the heart and blood vessels. Heart disease is the leading cause of early death (4 in 10) in people with RA. People are more likely to experience further serious heart problems or die after a heart attack if they have autoimmune conditions like RA. However, outcomes for people with autoimmune inflammatory arthritis have improved over the last 30 years, with earlier diagnosis and early treatment with diseasemodifying anti-rheumatic drugs (DMARDs) that aims to get inflammation as low as possible, as quickly as possible. It is very important for people diagnosed with inflammatory arthritis to discuss the risk of heart disease with their doctors. DMARDs to control inflammatory arthritis and a healthy eating and movement plan are also important for keeping your heart healthy.

For more information about heart health, visit the Heart Foundation website www.heartfoundation. org.nz or the Stroke Foundation website www.stroke.org.nz.

From Te Teko to Adelaide: a Māori physiotherapist’s health and career journey

By Dr Richard Griffiths

In 2021 Whatarangi collaborated with other colleagues, including AUT’s Dr Daniel O’Brien and Associate Professor Peter Larmer (the former Chair of Arthritis NZ’s Board of Trustees), to produce the first-ever study to investigate Māori men’s (tāne) lived experience of OA. Their research took inspiration from a 2019 study conducted by Nikita McGruer and colleagues, who interviewed a number of Māori women to learn more about their experiences of OA. In addition to their paper being published in the New Zealand Journal of Physiotherapy, Whatarangi and his team also did a poster presentation of their findings at the 2021 OA Basecamp which was held at the University of Auckland.

As the lead researcher, Whatarangi ensured his project and its “methodology” or approach were underpinned by various kaupapa Māori practices, procedures and frameworks. He added that Tom Ruakere, also from AUT, helped guide their team’s research journey through a Māori lens. Having researchers of Māori upbringing and understanding of how we operate as a people and as a culture was vital to the study. While some results reinforced some existing knowledge, there were some surprises. “Whakamā”, an event or experience that brings shame or embarrassment – in this case, having OA, was experienced by the male participants in different ways.

Another finding was that those tāne Māori that had been raised in urban areas “were significantly more impaired” or “alienated” than those men who had primarily lived elsewhere. The paper discusses for example, how citydwelling Māori have had limited access to te ao Māori or key elements that comprise their cultural identity. As an overall recommendation, Whatarangi suggested that “what I want to encourage or challenge all of our health force back home and our organisations is to be underpinned by Māori frameworks”.

Whatarangi’s journey

Originally from Te Teko, a small town in the eastern Bay of Plenty, Whatarangi Dixon completed his Bachelor of Health Sciences in Physiotherapy from Auckland University of Technology (AUT) in 2019. Following his fourth-year

placement as an undergraduate physiotherapy student at Whakatāne Hospital, he moved to Rotorua to work as a physiotherapist at QE Health.

Last year, he moved to Adelaide, Australia with his wife to take up a role as Senior Rehabilitation Consultant/Physiotherapist with the Altius Group.

He works with OA patients almost daily, with quite a notable proportion of his clients being military veterans with a range of osteoarthritic conditions. Pointing out some differences between the Australian and New Zealand health systems, Whatarangi feels there is a deeper level of collaboration between health professionals working in different sectors in Australia. “I love my new job because I’m not just doing my clinical work, but I’m able to liaise a lot more with their entire medical/treatment team – and I liaise with all stakeholders: the insurer, the employer if they’re still looking to try to keep in work. I also deal with many physios, occupational therapists, other specialists, and doctors. And we come up with this very holistic kind of plan to best help them, whether that’s helping them return to life, or return to health, or a return to work. It’s a full collaboration, looking at the whole person, not just one aspect. I can negotiate with all of these different parties to determine the best outcome for this person”.

Personal Health

Having initially considered studying medicine, Whatarangi’s life dramatically changed in 2014 when he was diagnosed with Guillain-Barre Syndrome (GBS), a very rare neurological condition which is similar to multiple sclerosis. GBS is when your immune system believes the nervous system is “a bad organism in the body” and attacks it aggressively.

Reflecting on the first year of his journey, which was a challenging time which saw him paralysed from the neck down, Whatarangi said that while he loved all his specialists, his physiotherapist was the most influential person in his recovery. As the health practitioner with him during the majority of his recovery period, he described her as “the person who opened up my eyes to what you could do as a physiotherapist”. Due to his experience and the fact that he thinks he has always been “instinctively a physio," Whatarangi became a physiotherapist.

“If we relate it to OA, the most difficult thing for people, in my opinion, is their independence. When we become dependent on others, it’s a very challenging place to be. I love being a part of people’s journeys to enable them to be much more independent again or as close as possible to where they were before they developed their condition or injury. That’s where my intrinsic drive comes from for wanting to be a physiotherapist”.

Blair Te Whatarangi Dixon (Ngāti Awa, Ngāti Manawa, Ngāti Raukawa ki Te Kaokaoroa-o-Pātetere) is a Māori physiotherapist, an advisor for the Medical Board of the Guillain-Barre Support Group New Zealand.

Blair Te Whatarangi Dixon

Nutrition FAQs

Q: Can I take apple cider vinegar for my arthritis?

Q:

A: Does fruit juice cause inflammation?

There is no harm. Although apple cider vinegar (ACV) is an arthritis-cure myth, other unrelated health benefits exist. Studies show moderate evidence that ACV may slightly lower blood sugars and inhibit appetite. There isn’t much evidence to suggest that it is specifically ACV that

effect. ACV is made from like all kinds of vinegar, and small amounts of

compounds in apples. There is no evidence that ACV affects arthritis, and no studies specifically for apple cider vinegar and

100% fruit juice with no added sugar can be part of a healthy diet when enjoyed on special occasions, the pulpier, the better. We don't recommend you drink fruit juice every day because it is high in sugar, and too much sugar leads to various health issues, including increased inflammation. Fruit juice is high in vitamin C, a powerful antioxidant that lowers inflammation. Real fruit juice with strong natural colours like cherry, pomegranate, and berry juices contain potent antioxidants with inflammationlowering ability. When you drink the juice instead of eating the whole fruit, you don’t get the complete fibre hit and miss out on other nutritional compounds.

Q: A:

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Fresh, frozen, canned or concentrated tomatoes aren’t necessarily bad for arthritis. In fact, in many cases, they are the opposite. If tomatoes aren’t a personal trigger for your arthritis symptoms, keep them in your diet. They are full of nutritional benefits and easy to access in New Zealand in fresh and minimally processed products. Allergies to tomatoes are rare; if there is a

reaction, it’s often an intolerance or sensitivity to tomatoes. If you think you have a sensitivity to tomatoes, test it. Remove them from your diet for two weeks, then introduce them back into your diet slowly in increasing amounts. You may find that you can tolerate a small amount, but higher amounts might cause some issues. If you find that eating tomatoes or certain tomato products causes symptoms, then don’t eat them.

Q: A: Are legumes good for people with arthritis?

Legumes are a plant family that produces seeds inside a pod, such as beans, peas, lentils, chickpeas, and soybeans. Adding legumes to your eating pattern is one way to simmer down inflammation, help maintain a healthy weight, and look after your gut. The daily recommended amount is a quarter cup per day. Legumes are a cheap and healthy source of protein and a great source of fibre, plant protein, minerals, B vitamins, and antioxidants in the diet. Legumes are low in saturated fat (a proinflammatory compound) compared to animal protein and high in fibre which is beneficial for your gut health. Fibre consumption has been linked to lower C-reactive Protein (CRP) levels in the blood. CRP is a marker of inflammation associated with conditions like rheumatoid arthritis, heart disease and diabetes.

Glucosamine and Chondroitin

By Tracey Kellett

Glucosamine and chondroitin are supplements often used to reduce joint pain and stiffness caused by Osteoarthritis (OA). If you would like to try glucosamine and/or chondroitin, check with your doctor and pharmacist first to make sure it’s safe for you, and that it won’t interact with any other medicines you take.

Claims glucosamine has the potential to slow cartilage deterioration in the joints and reduce pain in the process.

Glucosamine

Glucosamine is a naturally occurring carbohydrate substance in connective tissue. Commercially it is derived from shellfish and comes in glucosamine sulfate, hydrochloride, and often in combination with chondroitin. Claims include that glucosamine has the potential to slow cartilage deterioration in the joints and reduce pain in the process.

Evidence: Meta-analyses suggest that glucosamine (as sulfate, not hydrochloride) may lead to a slight reduction in symptoms of OA, although the results are somewhat inconsistent. It should be noted that the reduction in symptoms is minor, comparable to paracetamol, but not as consistent.

Dosage: You can safely supplement with glucosamine; the most common side-effect is flatulence. A standard dose is 300-500 mg three times a day, which adds up to a total daily dose of 900-1500 mg. The effectiveness of glucosamine is dose-dependent, and some studies suggest taking up to 2000-3000 mg daily, divided into multiple doses.

The most effective forms of glucosamine supplementation are glucosamine sulfate salts,

followed by glucosamine sulfate. Glucosamine hydrochloride is ineffective, and N-Acetylglucosamine is a distinct supplement that should not be confused with glucosamine.

You can buy glucosamine supplements at pharmacies and supermarkets. It is usually sold with chondroitin and has similar benefits taken alone or combined.

Chondroitin

Chondroitin is a naturally occurring carbohydrate in humans and animals that is integral in the structure of cartilage, the connective tissue that cushions joints. As a supplement, it is sold as chondroitin sulfate derived from cows, pigs, and marine life, mainly sharks. Claims include that it relieves joint symptoms from OA and slows down the progression of OA.

Evidence: A recent meta-analysis (2019) concluded that chondroitin sulfate supplementation is more effective than placebo in managing OA, with a moderate benefit for pain and a large effect on functional status. However, there was a high level of inconsistent results from trials. The reason for the inconsistencies was the risk of bias in the study design, the brand of chondroitin sulfate supplement used, and the study size. Some points about the results were that pharmaceutical-grade chondroitin sulfate was better than over-the-counter supplements, and the benefits remained at three and 12-month follow-ups.

Dosage: Taking chondroitin is safe, with only minor side effects reported. A standard dose is 1000-1200 mg daily in either one dose or two to three divided doses taken with food. Chondroitin sulfate supplements is available at pharmacies and supermarkets. It is usually sold with glucosamine and has similar benefits taken alone or combined.

Patient participation in defining best practice rheumatology service provision shows significant quality-of-life impacts

By Dr Valerie Milne

Arthritis NZ understands how difficult it can be for people living with rheumatic diseases to get consistent care, and that patients are concerned about variations in care between regions. These are two reasons why Arthritis NZ supports research into patient wellbeing and defining appropriate rheumatology care. In the May 2022 issue of Joint Support we reported on the progress of a study that sought views from patients about service standards that had previously been defined in a study with rheumatologists.

and whānau are respected and valued and (2) that patients receive the right care at the right time. Three rheumatology care principles were drafted directly from the study participants.

A rheumatology service should value individuals and their experiences through positive interpersonal interactions, supportive relationships and within a health system organised with the patients’ needs at the centre.

Participants were positive about the proposed service standards. Their views, after matching them with the standards, found three more service provision statements that were not fully covered by rheumatologists’ consensus best-practice statements. These patient-generated statements have now been included, with the rheumatologists’ consensus statement in a wider patient survey that will help form the finalised rheumatology standards for publicly-provided rheumatology services.

As well as providing input on the proposed bestpractice statements, this research demonstrates that patients can provide valuable insight into service provision, which can be harnessed to shape future services. The researchers are confident that the three principles and 25 statements of components of a best practice rheumatology service generated by this research can inform policy and service changes in New Zealand.

This work highlights the importance of considering patient perspectives when developing best-practice services and makes a strong case for further research in this field. Such a focus aligns with the increasing emphasis on consumer perspectives by Te Whatu Ora.

Rachel Ngan Kee, working with the guidance of rheumatologist Professor Rebecca Grainger, led focus groups and interviews with people living with inflammatory arthritis who were recruited by Arthritis NZ for the study.

Findings from the study show that the participants’ expectations of rheumatology care fit within two broad themes: (1) that the experiences of individuals

The research process and findings have now been published in BMC Rheumatology. The article is titled Patient participation in defining best practice rheumatology service provision in Aotearoa New Zealand: a qualitative study with service consumers and is available at https://rdcu.be/c414v free for anyone to read online or download.

Grant support for this research was provided by Arthritis NZ Mateponapona Aotearoa.

Professor Rebecca Grainger

Arthritis NZ Summer Scholarships 2022-2023

Auckland University of Technology (AUT) researchers were awarded Summer Scholarships worth $6,000 each to supervise talented students over the 2022/2023 summer. Arthritis NZ’s annual Summer Scholarship programme supports student arthritis research under the supervision of an experienced research professional working in academia and/or health service provision. The three Summer Scholarships are:

1. Investigating the experience of podiatrists providing

2. The experience of people with gout on the impact of gout flare triggers: a qualitative interview study. Gout flares are at the centre of patients’ experience of Gout Arthritis. The study will explore how triggers affect gout patients via face-to-face and online interviews. The study will offer a better understanding of how patients change their behaviour to avoid things that trigger gout flares and how these modified behaviours impact them. Study results could be potentially used for advocacy around the role of urate-lowering therapy and trigger avoidance behaviours to help with the long-term management of Gout Arthritis.

3. The association between dynamic plantar pressure and sonographic evidence of metatarsophalangeal joint synovitis in people with RA . The metatarsophalangeal joints (MTPJs) in the forefoot are the most common location of synovitis in RA patients and the main cause of foot pain. Over 85% of New Zealanders with the condition experience footrelated problems. The study aims to determine the association between dynamic plantar pressure and sonographic evidence of MTPJ synovitis in people with RA. The study will be the first to assess the relationship between “power doppler detected synovitis” and plantar pressure in people with RA. may also

inform the potential role of the use of ultrasound

Support Arthritis NZ whilst saving for your retirement!

Arthritis NZ is proud to be a charity partner of the Pathfinder KiwiSaver Fund. It’s an award-winning ethical KiwiSaver provider that is on a mission to grow investors’ individual wealth along with our collective well-being. Every time someone joins the plan and selects Arthritis NZ as their charity, Pathfinder donates 20% of that person's management fee (out of their own pockets) to us! As a result, last year we received over $4,500! So if you want your KiwiSaver investment to help support New Zealanders affected by Arthritis, consider switching to the Pathfinder KiwiSaver Fund.

For more information about the Pathfinder KiwiSaver Fund, to view their Product Disclosure Statement, or to sign up, visit www.pathfinder.kiwi

Meet two Pathfinder KiwiSaver members: Emma and Paul

Why do you choose to have your KiwiSaver with Pathfinder?

E: I am passionate about the outdoors and nature, and it’s important to me to protect it, so I chose to invest my KiwiSaver with Pathfinder. They invest transparently and sustainably, which aligns with my views.

P: My family and I lived overseas for several years, and when we returned to New Zealand we appreciated what a special country this is. I wanted to invest my KiwiSaver in a way that recognised that, as well as the common aspirations most of us have

in life, and was also something my children could be proud of. Plus, the returns have been excellent!

Why did you choose to support Arthritis NZ?

E: I have watched how debilitating arthritis is for my mother. Once a keen tennis player and active walker, she now suffers daily and can scarcely move. I believe in providing for people in the community who need a bit of extra help, and I love how Arthritis NZ offers community support and provides resources to help Kiwis live happier, healthier lives. Supporting them was an easy choice!

P: Some of my family and friends have arthritis, and I appreciate the work Arthritis New Zealand does. I also support their scope – from education and lobbying to practical community support and funding research. I have been a member of the Pathfinder Investment Committee for some time now, and I am pleased to have helped Arthritis NZ.

What would you say to someone considering switching to Pathfinder and supporting Arthritis New Zealand?

E: Knowing what your KiwiSaver is invested in is important, and if you want to generate great returns while doing good in our community, you can’t go wrong. Everybody wins!

P: Clearly I am biased, but I genuinely believe it is the best KiwiSaver scheme in New Zealand. I think we have shown that it is possible to have strong financial returns while investing positively and ethically. It’s also just a simple way people can support Arthritis NZ financially!

A word from Philip

Kia ora,

As I write this column, we are slowly understanding Cyclone Gabrielle’s impact on communities throughout the North and East of the North Island. Our thoughts are with those whose lives have been turned upside down by massive disruption and loss. We are looking at ways to support people during national emergencies like this, especially those with arthritis. We know that everyday tasks are difficult to complete at the best of times, and these events make it more difficult.

We are also investing in several online arthritis self-management programmes to provide practical assistance for those with arthritis. We launched MyJointPain (www.myjointpain.co.nz) 18 months ago, which focuses on those with Osteoarthritisover 5,000 users have visited this site since it was launched. For those with rheumatoid arthritis, we are working with rheumatology nurses and some rheumatologists to develop MyRA, which is a website that will focus on providing better management and useful resources for those with RA. We hope to launch this in July 2023.

These self-management tools and a range of support through Arthritis Assist are practical ways to help those with arthritis within New Zealand. This would not be possible without all of those donors who financially support us. 80% of our funding comes from donations and grants, which enable us to provide these services.

We also appreciate the ongoing support from our volunteers, who continue to assist us in many ways. The recent Garden Amble in Whanganui (see page 15) was just one example of this support.

I don’t often get the chance to acknowledge our amazing staff and the commitment to supporting our vision of improving the life of every person affected by arthritis. They all go above and beyond to provide help, from assisting at the recent families

and teens camps, taking phone calls or posting interesting articles online. I appreciate all of their efforts.

To everyone, take care, and as always, I am happy to receive your feedback.

Kia Kaha, Philip Kearney, Chief Executive

Accessible packaging video campaign

Arthritis New Zealand is part of the Accessible Product Design Alliance (APDA), an initiative by Arthritis Australia to promote the importance of packaging being easy to access for people with arthritis and other long-term conditions.

The ability to open packaging easily is an ongoing challenge for people with arthritis and has significant implications, including the ability to access food and medicines. Often individuals with arthritis can experience limited dexterity and fine motor coordination and typically have weaker grips than those without arthritis. APDA invited people to take part in an awareness campaign late last year

Ecolean received the Accessible Packaging Design Special Award in 2020

Have your say... before the elections!

It’s election year and Arthritis NZ is gearing up for meeting health spokespeople and letterwriting to political parties that are likely to be in parliament.

Many topics related to arthritis care require attention, but of course, not all of these can be covered. Arthritis NZ needs to focus on just one or two topics that are achievable and would have a positive impact on the lives of people living with arthritis.

What will these be? More rheumatologists and shorter waiting times? Better access to mental health and allied health services? Cheaper GP visits for multiple visits? More training for GPs and allied health professionals in rheumatic diseases? Better access to advanced medicines and aids or improved disability services? Or should it be something more personal like home help / working with employers / financial assistance?

This is a chance for you to let us know what you think we should cover. If there is a topic concerning your arthritis that is important to you that you think the incoming government can help with, please fill in the form below and return it to us by post in the enclosed envelope or email your topic to info@arthritis.org.nz.

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Amble, Ramble never a Gamble

Written by a member of the Whanganui Arthritis Support Group

Depending on your mobility, you can amble or ramble through the Whanganui Arthritis Support Group annual garden event.

Every year in September, the support group committee asks itself, “shall we have an Arthritis garden amble this year?” while forgetting the effort needed and only remembering the look of appreciation and inspiration of the amblers leaving the beauty of the gardens, the appreciative comments as they leave in anticipation of “where’s the next garden?”.

We do it because it brings the community together, inspires younger gardeners, raises funds for Arthritis NZ to continue their education and research, and gives amblers a day to be outside surrounded by the beauty of plants. The gardens are in varying shapes and sizes, some are park-like, others well-

established, and others are in the planning and developing stages.

The Whanganui Arthritis Support Group would like to thank the gardeners who take the time and effort to prepare their gardens and thank you to the garden amble committee who met and organised the event, and the volunteers on the day. Thank you to the businesses in town who sponsor the event’s advertising and to the businesses who sell the tickets.

Keep your life moving

Proud sponsors of Arthritis New Zealand

Committee members Lynne Powley and Karen Hurndell

Group Chair David Orr with Joan Alabaster in her garden.

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Your monthly gift helps expand our resources and services, reach more people in need, and work towards a future where arthritis is less of a barrier to a happy and healthy life.

Whether you give $10, $25 or $50 per month, your 12 gifts will make a year-long impact ensuring people with arthritis have the resources and support they need to thrive all year long.

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