Background Analgesics are recommended in current guidelines, but non-use and inadequate prescription have been reported in patients with knee and/or hip osteoarthritis (OA). Furthermore, predictors of analgesic use have not yet been clarified.
Objectives To (i) describe the use of analgesics; and (ii) determine factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center.
Methods Data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) were used. 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.
Results Analgesic use was reported by 62% 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.
Conclusions Less than two-third of patients with knee and/or hip OA referred to an outpatient center reported analgesic use, which seems to be indicative for under-use. Although multiple, mostly disease-related factors were associated with analgesic use, it remained predominantly unexplained. Our findings may 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.
Disclosure of Interest None declared
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