Osteoarthritis Management: Determine What Patients Know, Then Fill in Gaps

Osteoarthritis (OA) is the leading cause of disability in the United States.¹ Current OA management strategies include symptomatic relief and reducing disease progression through lifestyle management, nonpharmacologic and pharmacologic approaches, and surgery.² Health literacy is critical for patients to navigate the self-management of OA.²

A previous survey investigated participants' perceptions of pain and self-management strategies for pain relief. The original researchers gave a survey to adults in Australia aged 45 to 74 years. Patients with low health literacy had suboptimal knowledge about pain relief choices and low literacy also had a significant association with inappropriate selection of self-management.²

Based on that information, this study’s researchers examined the outcomes of the original survey further, focusing on its relevance has to community pharmacists. The study included 697 (10%) eligible patients who answered 6 questions on the original survey self-reporting OA symptoms.²

Many participants did not self-identify their pain as OA; only 40.8% of participants reported their pain as OA.² Pharmacists should have tools to identify patients in the community pharmacy who may have OA.²

Identifying these patients could lead to faster diagnosis, earlier treatment, and improved symptomatic relief.The most common participant-reported joint pain was in the knees, hips, and hands. Most patients (74.4%) were overweight or obese.²

Only 3.5% of participants had used a community pharmacist as a resource for pain management, although patients purchased 75% to 80% of analgesics at community pharmacies.² On the survey, 38% of patients reported self-managing their pain, but only 17% used an analgesic medication recommended by a pharmacist.²

Participants with low health literacy were less likely to seek advice from anyone regarding pain management, presenting an opportunity for pharmacists to further engage with this patient population and ask questions about their symptoms.² Recommendations for OA management include many non-prescription drugs, empowering pharmacists to support evidence-based management choices.

The pharmacist's responsibility does not end in medication selection. In patients already using analgesics for pain control, pharmacists need to address medication adherence for improved symptom control. More than 75% of patients did not self-report high medication adherence for any analgesics category.²

More research is needed to see whether patients' ability to self-manage OA pain would improve with increased community pharmacist intervention.²

About the Author

Lindsey Sawtelle is a 2022 PharmD candidate at the University of Connecticut.

References

1. Centers for Disease Control and Prevention. Arthritis. Last Updated: November 3, 2021. Accessed March 24, 2022. Accessed from: https://www.cdc.gov/chronicdisease/resources/publications/factsheets/arthritis.htm#:~:text=In%20the%20United%20States%2C%2024,form%20of%20arthritis%20is%20osteoarthritis
2. McLachlan AJ, Carroll PR, Hunter DJ, Wakefield TAN, Stosic R. Osteoarthritis management: Does the pharmacist play a role in bridging the gap between what patients actually know and what they ought to know? Insights from a national online survey [published online ahead of print, 2022 Jan 8]. Health Expect. 2022;10.1111/hex.13429. doi:10.1111/hex.13429