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

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• Alternative Title:
  Arthritis Care Res (Hoboken)
• Personal Author:
  Abbate, Lauren M. ; Jeffreys, Amy S. ; Coffman, Cynthia J. ; Schwartz, Todd A. ; Arbeeva, Liubov ; Callahan, Leigh F. ; Negbenebor, Nicole A. ; Kohrt, Wendy M. ; Schwartz, Robert S. ; Vina, Ernest ; Allen, Kelli D.
• Description:
  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.
  
  
• Subjects:
  Administration, Oral Administration, Topical Aged Ambulatory Care Ambulatory Care Facilities Analgesics, Non-Narcotic Anti-Inflammatory Agents, Non-Steroidal Article Conservative Treatment Female Follow-Up Studies Humans Injections, Intra-Articular Logistic Models Male Middle Aged Multivariate Analysis North Carolina Osteoarthritis, Hip Osteoarthritis, Knee Pain Measurement Randomized Controlled Trials As Topic Risk Assessment Severity Of Illness Index Treatment Outcome

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• Source:
  Arthritis Care Res (Hoboken). 70(8):1141-1149
• Pubmed ID:
  29125899
• Pubmed Central ID:
  PMC5945338
• Document Type:
  Journal Article
• Funding:
  P60 AR049465/AR/NIAMS NIH HHS/United States ; P30 DK048520/DK/NIDDK NIH HHS/United States ; K23 AR067226/AR/NIAMS NIH HHS/United States ; I01 HX000449/HX/HSRD VA/United States ; R01 AR071440/AR/NIAMS NIH HHS/United States ; P30 AG028716/AG/NIA NIH HHS/United States ; T32 AG000279/AG/NIA NIH HHS/United States ; U01 DP006266/DP/NCCDPHP CDC HHS/United States ; R01 AR059673/AR/NIAMS NIH HHS/United States ; CER-1306-02043/PCORI/Patient-Centered Outcomes Research Institute/United States ; P60 AR064166/AR/NIAMS NIH HHS/United States
• Volume:
  70
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8d7796f34f0e8d8e47a46cb9ab20e2cce64b246d74cef86e209b3e4acba26164
• Download URL:
  https://stacks.cdc.gov/view/cdc/87051/cdc_87051_DS1.pdf
• File Type:
  [PDF - 435.26 KB ]