TY - JOUR
T1 - Analgesic use in patients with knee and/or hip osteoarthritis referred to an outpatient center
T2 - a cross-sectional study within the Amsterdam Osteoarthritis Cohort
AU - Knoop, Jesper
AU - van Tunen, Joyce
AU - van der Esch, Martin
AU - Roorda, Leo D.
AU - Dekker, Joost
AU - van der Leeden, Marike
AU - Lems, Willem F.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Although analgesics are widely recommended in current guidelines, underuse and inadequate prescription of analgesics seem to result in suboptimal treatment effects in patients with knee and/or hip osteoarthritis (OA). This study aimed (i) to describe the use of analgesics; and (ii) to determine factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center. A cross-sectional study with data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) was conducted. Self-reported use of analgesic (yes/no) was administered and subdivided into acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs, including coxibs) and opioids. Logistic regression analyses were performed to analyze the association between analgesic use and disease-related, predisposing and enabling factors. Analgesic use was reported by 63% of the patients, with acetaminophen, NSAIDs and opioid use reported by 50, 30 and 12%, respectively. Factors related to analgesic use were higher pain severity, longer duration of symptoms, higher radiographic hip OA severity, overweight/obesity and psychological distress. These factors explained 21% of the variance of analgesic use. More than one-third of patients with established knee and/or hip OA referred to an outpatient center did not use any analgesics. Although multiple, mostly disease-related associated factors were found, analgesic use remained predominantly unexplained. Our study seems to indicate that prescription of analgesics should be guided more dominantly by clinical symptoms and needs, and preceded by a thorough shared decision-making process between patient and physician.
AB - Although analgesics are widely recommended in current guidelines, underuse and inadequate prescription of analgesics seem to result in suboptimal treatment effects in patients with knee and/or hip osteoarthritis (OA). This study aimed (i) to describe the use of analgesics; and (ii) to determine factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center. A cross-sectional study with data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) was conducted. Self-reported use of analgesic (yes/no) was administered and subdivided into acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs, including coxibs) and opioids. Logistic regression analyses were performed to analyze the association between analgesic use and disease-related, predisposing and enabling factors. Analgesic use was reported by 63% of the patients, with acetaminophen, NSAIDs and opioid use reported by 50, 30 and 12%, respectively. Factors related to analgesic use were higher pain severity, longer duration of symptoms, higher radiographic hip OA severity, overweight/obesity and psychological distress. These factors explained 21% of the variance of analgesic use. More than one-third of patients with established knee and/or hip OA referred to an outpatient center did not use any analgesics. Although multiple, mostly disease-related associated factors were found, analgesic use remained predominantly unexplained. Our study seems to indicate that prescription of analgesics should be guided more dominantly by clinical symptoms and needs, and preceded by a thorough shared decision-making process between patient and physician.
KW - Acetaminophen
KW - Acetaminophen/therapeutic use
KW - Aged
KW - Analgesics
KW - Analgesics/therapeutic use
KW - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
KW - Cross-Sectional Studies
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Non-steroidal anti-inflammatory drugs
KW - Opioids
KW - Osteoarthritis
KW - Osteoarthritis, Hip/diagnosis
KW - Osteoarthritis, Knee/diagnosis
KW - Outpatients
KW - Pain
KW - Severity of Illness Index
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UR - http://www.scopus.com/inward/citedby.url?scp=85027683583&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00296-017-3785-3
DO - https://doi.org/10.1007/s00296-017-3785-3
M3 - Article
C2 - 28821939
SN - 0172-8172
VL - 37
SP - 1747
EP - 1755
JO - Rheumatology international
JF - Rheumatology international
IS - 10
ER -