OBJECTIVE: To examine whether the current widespread use of antiinflammatory drugs may reflect a lack of informed choice (i.e., unawareness of adverse effects or potential treatment alternatives) among older patients with knee osteoarthritis (OA). METHODS: Consecutive patients with symptomatic knee OA (n = 100) completed a questionnaire to assess their awareness of drug toxicity. Patients also completed an Adaptive Conjoint Analysis task so that the influence of providing an additional treatment alternative on patient preferences for nonselective nonsteroidal antiinflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors could be assessed. RESULTS: Fifty-four percent of the patients surveyed were unaware of any adverse effects related to NSAIDs and 80% were unaware of any toxicity related to COX-2 inhibitors. When given a choice between NSAIDs and COX-2 inhibitors, 57% of patients preferred COX-2 inhibitors over NSAIDs. When presented with a third less effective, but safer alternative, 100% of patients switched preferences to the safer, albeit less effective, option. CONCLUSIONS: Our findings suggest that the widespread use of NSAIDs may reflect lack of informed choice among older patients with OA.
OBJECTIVE: To examine whether the current widespread use of antiinflammatory drugs may reflect a lack of informed choice (i.e., unawareness of adverse effects or potential treatment alternatives) among older patients with knee osteoarthritis (OA). METHODS: Consecutive patients with symptomatic knee OA (n = 100) completed a questionnaire to assess their awareness of drug toxicity. Patients also completed an Adaptive Conjoint Analysis task so that the influence of providing an additional treatment alternative on patient preferences for nonselective nonsteroidal antiinflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors could be assessed. RESULTS: Fifty-four percent of the patients surveyed were unaware of any adverse effects related to NSAIDs and 80% were unaware of any toxicity related to COX-2 inhibitors. When given a choice between NSAIDs and COX-2 inhibitors, 57% of patients preferred COX-2 inhibitors over NSAIDs. When presented with a third less effective, but safer alternative, 100% of patients switched preferences to the safer, albeit less effective, option. CONCLUSIONS: Our findings suggest that the widespread use of NSAIDs may reflect lack of informed choice among older patients with OA.
Authors: Paul R Falzer; Howard L Leventhal; Ellen Peters; Terri R Fried; Robert Kerns; Marion Michalski; Liana Fraenkel Journal: Pain Pract Date: 2012-07-02 Impact factor: 3.183
Authors: Emily Bowen; Rabih Nayfe; Nathaniel Milburn; Helen Mayo; M C Reid; Liana Fraenkel; Debra Weiner; Ethan A Halm; Una E Makris Journal: Pain Med Date: 2020-05-01 Impact factor: 3.750