Medication and supplement use for managing joint symptoms among patients with knee and hip osteoarthritis: A cross-sectional study

Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA 02111, USA.
BMC Musculoskeletal Disorders (Impact Factor: 1.72). 03/2012; 13(1):47. DOI: 10.1186/1471-2474-13-47
Source: PubMed


The purpose was to determine the professionally-guided and self-guided medication and supplement use for joint symptom management among patients with knee and/or hip osteoarthritis (OA) in an urban hospital-based outpatient orthopedic practice.
The study design was cross-sectional. Patients diagnosed by radiographs and clinical symptoms with knee and/or hip OA were recruited from an inner-city hospital-based outpatient orthopaedic office. A total of 184 patients were queried for their participation. Four investigator-generated, interview-based questionnaires were used. Sampling error was ±7.84%. Logistic regression models and Fisher Exact Tests were performed to determine factors that may be associated with negative behaviors related to medication or supplement use (e.g., reporting medication as ineffective, using multiple medications in the same day to manage symptoms). Odds ratios (OR) and 95% confidence intervals (CI) were calculated for significant findings.
Among the 162 participants, a majority reported professionally-guided recommendations and over 40% reported at least one self-guided intervention. 37 participants reported dual-use during the same day, and among those,15 reported dual-use at the same time. Among participants taking multiple interventions in the same day, 40.5% reported using prescription and over-the-counter medications. Use of multiple medications or supplements in one day was more common among participants who reported OA at multiple joints (OR [95% CI]=2.48 [1.03 to 5.96]) but less common among participants who did not complete high school (OR [95% CI]=0.26 [0.08 to 0.83]). Of the 15 participants who reported dual-use at the same time, 11 were professionally-guided, 5 were professional and self-guided, and 1 was solely self-guided. Overall, 28% of participants reported their intervention as ineffective, sought an alternative method to achieve symptomatic relief, or were prescribed a stronger medication. Participants who reported not always taking their medication consistently for 2 weeks were more likely to report their medication as ineffective (OR [95% CI]=2.87 [1.19 to 6.92]).
Both professional and self-guided medications and supplements are used by inner city OA patients to manage their joint symptoms. It is important for clinicians to discuss with these patients how to effectively manage multiple joint symptoms, the importance of taking medications as prescribed, and what they should if they believe a treatment is ineffective or their medication runs out.

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Available from: Jeffrey B Driban, Oct 04, 2015
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    • "Therefore, it is essential for them to be familiar with the various treatment options to optimize care. Many studies in different countries have evaluated OA either in the hospitals or in PHC-settings,318–2022 there have been a very few attempts to identify a specific impact of this condition and its symptoms among physicians practicing in Saudi Arabia. Therefore, this study aimed to assess knowledge, attitude, and practice of PHC physicians in the management of OA. "
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    ABSTRACT: Primary health care (PHC) physicians manage most patients with osteoarthritis (OA). In Saudi Arabia, very little is known about the management of OA by PHC physicians. This study aims to assess knowledge, attitude, and practice of PHC physicians in the management of OA. During October 2011, a cross-sectional survey was conducted on physicians who were practicing at the primary care centers in AlJouf province of Saudi Arabia. The physicians were asked to fill a valid questionnaire comprised of 35 closed ended questions, 6 items about their socio-demographic characters, and a very well modified 29 questions about their knowledge, attitude, and practice in the management of OA. Data was processed and analysed using SPSS (version 16) program, the level of significance was set as Chi-square test was applied for analysis of categorical data. Response rate (77/90=85.6% yielded 77 questionnaires for analysis. The mean ± SD age of respondents was 38 (12.3) years. Majority of the physicians surveyed, 58 (75.3%) considered OA as a common health problem in Saudi Arabia. Only 28 (36.4%) physicians surveyed will achieve continuity of care for OA, whereas more than half (n=44; 57.1%) will refer OA immediately or later to the specialists. The proportion of continuity of care for OA among physicians with diplomas was more than that found among general practitioner (57.1% vs 34.1%; <.05). Only 30 (39%) of physicians appeared to know the radiographic changes associated with OA. 21 (27.3%) of physicians manage an average of 5-10 patients with OA per week. Almost 3/4 (th) of the physicians (n=57; 74%) prescribe NSAIDs, and only (n=14; 18.2%) prescribe acetaminophen for OA. Less than 1/5 (th) of the physicians surveyed (n=12; 15.6%) prescribe herbal medicine for OA. Almost all physicians subscribe to regular training programs about OA. Appropriate attitude with lack of knowledge was found, and practice of our physicians with regards to this disorder appeared inappropriate. More education focusing on the disorder is recommended.
    Journal of the Nigeria Medical Association 10/2012; 53(4):213-9. DOI:10.4103/0300-1652.107556
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    ABSTRACT: To identify and validate previously established phenotypes of knee osteoarthritis (OA) based on similarities in clinical patient characteristics. Knee OA patients (N = 551) from the Amsterdam Osteoarthritis (AMS-OA) cohort provided data. Four clinical patient characteristics were assessed: upper leg muscle strength, body mass index (BMI), radiographic severity (Kellgren/Lawrence [KL] grade), and depressive mood (the Hospital Anxiety and Depression Scale [HADS] questionnaire). Cluster analysis was performed to identify the optimal number of phenotypes. Differences in clinical characteristics between the phenotypes were analyzed with ANOVA. Cluster analysis identified five phenotypes of knee OA patients: "minimal joint disease phenotype", "strong muscle strength phenotype", "severe radiographic OA phenotype", "obese phenotype", and "depressive mood phenotype". Among patients with knee OA, five phenotypes were identified based on four clinical characteristics. To a high degree, the results are a replication of earlier findings in the OsteoArthritis Initiative, indicating that these five phenotypes seem a stable, valid, and clinically relevant finding. Copyright © 2015. Published by Elsevier Ltd.
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