Potential Role of Cost and Quality of Life in Treatment Decisions for Arthritis‐Related Knee Pain in African American and Latina Women

Abstract

Objective. The present study was undertaken to investigate whether Latina and African American women with arthritis-related knee pain and primary care providers who treat them believe their treatment decisions would benefit from having more information about the impact of treatment on their quality of life, medical care costs, and work productivity.Methods. We conducted 4 focus groups of Latina and African American women over age 45 years who had knee pain. We also conducted 2 focus groups with primary care providers who treated Latina and African American women for knee pain. The participants were recruited from the community. They were asked their opinions about a decision tool that presented information on a range of treatment options and their impacts on quality of life, medical care costs, and work productivity. They were asked whether providing this information would help them make better treatment decisions. We analyzed the focus group transcripts using ATLAS.ti.Results. We found that minority women and primary care providers endorsed the use of a decision-making tool that provided information of the impact of treatment on quality of life, medical care costs, and work productivity. Providers felt that patients would benefit from having the additional information but were concerned about its complexity and some patients' ability to comprehend the information.Conclusion. Latina and African American women could make more informed treatment decisions for their knee pain using a decision-making tool that provides them with significant information about how various treatment options may impact their quality of life, medical care costs, and workforce productivity.

Qualitative evidence synthesis using meta-ethnography to understand the experience of living with osteoarthritis pain

“…17,21,64,67,79,93,114,117,120,137,140,159,164 We included findings from 118 reports (105 unique samples) published between 1998 and 2021. 1–5,7,9–13,15,16,18,20,22–27,31 , 33,34,37,39,40,43-46,48,49 , 52–58,60,61,63,65,66,68–78 , 80-82,86-92,94-101 , 103–105,108–110,112,113,115,118,119 , 121,122,124-130,132-134,141-147 , 149–155,158,160–162,165–169 Table 2 presents the author, year of publication, country, condition, number of participants, and age. Most studies explored the experience of knee and hip osteoarthritis, and 30 of these specifically aimed to understand decision-making for hip or knee joint replacement surgery.…”

“…17,21,64,67,79,93,114,117,120,137,140,159,164 We included findings from 118 reports (105 unique samples) published between 1998 and 2021. [1][2][3][4][5]7,[9][10][11][12][13]15,16,18,20,[22][23][24][25][26][27]31,33,34,37,39,40,[43][44][45][46]48,49,[52][53][54][55][56][57][58...…”

Development of a personalized shared decision-making tool for knee osteoarthritis and user-testing with African American and Latina women

“…Inclusion of the financial impact of a patient’s treatment decisions may strengthen the effectiveness of a SDM tool. [ 22 ] Based on the results of the user-testing, the knee osteoarthritis SDM tool provides a framework for discussion of treatment options and likely outcomes. This may result in better patient compliance for the treatment option selected.…”

“…Focus group patients (African American and Latina women) prioritized information on likely pain and activity levels, and approximately 20% of patients, primarily those who were financially supporting their families, were interested in lost productivity. [ 22 ] The SDM tool was programmed to compare likely outcomes at 1, 5, and 10 years of two treatment pathways versus no treatment. Treatment choices for knee osteoarthritis patients included weight loss resulting from diet and exercise (and possibly physical therapy), increased physical activity, pain medication, injections (intraarticular corticosteroids or hyaluronic acid), nonsteroidal anti-inflammatory drugs and glucosamine chondroitin, unloader knee braces, and total knee arthroplasty.…”

A synthesis of qualitative research to understand the complexity behind treatment decision-making for osteoarthritis

“…Primary studies underpinning findings. your own expert can be hard work[21][22][23][24][25][26]28,30,31,[34][35][36]42,44,46,[49][50][51]55,60,[63][64][65]69,[71][72][73][74][75][76][77]79,80,82,83,[85][86][87][88][89][90][93][94][95][96][97][98]100,103,105,107,110,113,…”