SAT0332 The personal impact of osteoarthritis on individuals and how they use therapies: The arthritis care OA nation 2012 survey

Abstract

Background The impact of osteoarthritis (OA) on individuals and how they use therapies is still relatively under-studied and offers opportunities to improve current therapeutic strategies. Objectives To understand the impact of OA on important activities such as employment and to explore how individuals are treated and how they use their therapies. Methods An on-line survey of randomly selected people with self-reported OA from a large UK research panel. Results 4,043 people were invited with 2001 respondents (49% response rate, 56% women, mean age 65 years). Impact: 52% reported that OA had a large impact on their lives, and 58% reported making adjustments to their life because of OA. Walking and exercise had been reduced or stopped by half the respondents. 15% had taken early retirement, on average 7.8 years earlier than planned. The average increased cost per annum per person due to OA was about £500. Treatment: Almost 40% of respondents reported their OA treatment as not very/not at all effective. Nearly half (48%) would not seek medical help until their pain was frequently unbearable, with women more likely to wait for such symptoms than men (53% women vs 40% men). After OA diagnosis, 18% do not consult their primary care doctor again, with a further 41% not visiting regularly. In consultations, only half reported a discussion on pain, and a third discussed OA impact; fewer reported discussing their fears (21%) or goals of management (15%) – over half (59%) felt they had not agreed a care-plan with their doctor. Doctors were seen as the major source of information (53%), with search engines (38%) and friends/family (19%) other sources. Awareness of self-management was generally much higher than take-up eg 64% were aware that increasing exercise was important while only 36% did this; most (87%) who increased exercise found it beneficial. 62% were prescribed oral OA medication, with topical therapies (47%), physiotherapy (38%) and steroid injections (28%) the commonest therapies used. Over-the-counter medications had been used by 25%, a third without their doctor’s knowledge. Half used their medications every day, while 20% of those whose treatment was not effective reported irregular use of painkillers though without advice to do so. The majority (71%) reported varying degrees of persistent pain despite taking all prescribed medication. Over half had future concerns related to mobility (60%), maintaining independence (52%) and coping with everyday practical activities (51%). Conclusions OA has significant economic impact on individuals, especially related to employment. Many people did not seek help until symptoms were severe, and primary care doctors were still seen as the leading source of information on OA, although most did not develop a care plan with their patients. Self-management strategies were under-utilised, though effective when employed. Current treatment strategies still leave most people in pain with significant fears for the future. Disclosure of Interest None Declared

Pain reduction with oral methotrexate in knee osteoarthritis, a pragmatic phase iii trial of treatment effectiveness (PROMOTE): study protocol for a randomized controlled trial

“…Current medical therapy does not provide satisfactory pain relief in the majority of people with OA [ 64 ]; with the rapidly ageing population the prevalence of OA will continue to rise over the next decade. Unless the barriers to successful treatment of OA are overcome, the already considerable social and economic burden will soon reach an unsustainable level.…”