Patients' awareness, utilization, and satisfaction with treatment modalities for the management of their osteoarthritis.

The objective of this study was to evaluate the knowledge, awareness, utilization, and satisfaction of patients with different treatment modalities for osteoarthritis (OA). Patients with a diagnosis of OA of the knee or hip who had attended a rheumatology referral clinic over the preceding 2 years were eligible. A six-page self-administered questionnaire was mailed to them. Responses were anonymous. One hundred and six completed questionnaires were returned. The average age of the respondents was 64 years and included 71 females. Ninety-four percent of respondents had at least 8 years of formal education, and 75% had had OA for at least 5 years. Seventy-five percent successfully defined OA. The majority had heard of most treatment modalities. Seventy-one percent had tried cyclooxygenase-2 inhibitors (COXIBs), 79% analgesics, and 56% physiotherapy. Twenty-six percent had had surgery for their OA. Of those that had tried the various treatment options, the most satisfaction occurred with surgery, pool therapy, walking aids, and narcotic analgesics. Fifty-five percent found traditional nonsteroidal anti-inflammatory drugs (NSAIDs) helpful and 65% benefited from the COXIBs. Treatment reported as providing the most improvement in function was surgery, followed by steroid injections, COXIB therapy, and traditional NSAIDs. Treatment modalities providing the most symptomatic improvement were surgery, followed by COXIBs and steroid injections. When treatment options were compared, their rank ordering differed when considering overall satisfaction, functional improvement, and symptomatic relief. The participants in this study were well informed as to the nature of their disease and its treatment. A wide number of therapies had been tried, most of which were well tolerated. According to patient perception, those undergoing surgical treatment had the best improvement in symptoms and function. For those using anti-inflammatories (NSAIDs or COXIBs) improvement occurred in >50%, though this was less than for physiotherapy and analgesics. Based on this cohort of patients, treatments that were rated highly (such as surgery) were not necessarily those that were the most widely experienced. Conversely, those therapies that were the most widely accessed (such as analgesics) were not necessarily those that provided the maximum perceived benefit. We conclude that in the continued absence of specific disease-modifying therapies for OA, multiple therapeutic options need to be explored to address individual patient's functional and symptomatic needs.