5 years ago

Demographic and Clinical Factors Associated with Non-Surgical Osteoarthritis Treatment Use Among Patients in Outpatient Clinics

Ernest. Vina, Robert S. Schwartz, Liubov Arbeeva, Cynthia J. Coffman, Lauren M. Abbate, Kelli D. Allen, Wendy M. Kohrt, Todd A. Schwartz, Nicole A. Negbenebor, Leigh F. Callahan, Amy S. Jeffreys
Objective To identify patient demographic and clinical characteristics associated with osteoarthritis (OA) treatment use. Methods This was a secondary data analysis of three clinical trials among patients with hip or knee OA conducted in 1) Duke Primary Care practices, 2) the Durham Veterans Affairs Health Care System (DVAHCS), and 3) the University of North Carolina-Chapel Hill (UNC). At baseline, participants reported socio-demographic characteristics, OA-related pain and function, and OA treatment use including oral analgesia, topical creams, joint injections and physical therapy. Separate, multivariable logistic models (adjusted for clustering of clinics and providers for Duke and VA cohorts) were used to estimate odds ratios and 95% confidence intervals (OR, 95% CI) for the associations between participant characteristics and each type of OA treatment. Results Oral analgesic use was reported by 70-82% of participants across the three cohorts. Physical therapy, knee injections, and topical creams were used by 39%-52%, 55-60%, and 25-39% of participants, respectively. In multivariable models, worse pain, stiffness, and function, per 5-unit increase, were associated with greater odds of using any oral analgesic for the Duke (OR=1.18 (1.08, 1.28)) and UNC (OR=1.14 (1.05, 1.24)) cohorts but not for the VA cohort (OR=1.04 (0.95, 1.14)). For all three cohorts, Non-Whites had higher odds of use of topical creams compared to Whites. Conclusion Results suggest potential under-utilization of therapies other than oral analgesia. Patient characteristics may affect OA treatment use, and understanding the relationship between these factors and OA treatment preferences may improve adherence to OA treatment guidelines. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/acr.23466

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