Background/Purpose:

Most published clinical practice guidelines for the management of osteoarthritis recommend exercise as a primary self-management strategy. Despite this, less than one-third of primary care physicians provide exercise advice during office visits. This study’s purpose was, for 2002 and 2014, to: 1) estimate percentage of US adults with arthritis whose health care provider (HCP) advised them to exercise to manage their arthritis, and 2) describe sociodemographic and health-related subgroups with low prevalence of HCP exercise advice.

Methods:

The National Health Interview Survey (NHIS), is an ongoing survey of the civilian, non-institutionalized population and gathers data on a variety of health topics. We analyzed 2002 and 2014 data (sample sizes = 31,044 and 36,697, respectively). Doctor-diagnosed arthritis was defined as a ‘yes’ to: “Have you ever been told by a doctor or other health care professional that you have arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia?” HCP advice for exercise was defined as a ‘yes’ to “Has a doctor or other health professional EVER suggested physical activity or exercise to help your arthritis or joint symptoms?” Age-standardized prevalence (%) and 95% confidence intervals (CI) of HCP advice for exercise was calculated overall and by sociodemographic characteristics (age, sex, race/ethnicity, and education) and health-related characteristics (arthritis-related activity limitation (AAAL), self-rated health (excellent/very good, good, fair/poor), body mass index (BMI, <25.0, 25.0-<30 and 30.0+), smoking status (current, former, never), physical activity level (inactive, insufficient, meets recommendations) and having a primary care provider (yes, no). All analyses accounted for NHIS’ complex survey design. Prevalence of HCP advice for exercise was considered low if <50% in 2002 and <60% in 2014.

Results:

In 2002 and 2014, age-standardized prevalence of HCP advice for exercise among adults with arthritis was 51.9% (CI 49.9-53.8%) and 61.0% (CI 58.6-63.4%), respectively (a 17.5% increase). In 2002, groups with low age-standardized prevalence of HCP advice for exercise were: men; Non-Hispanic Others; those with less than a high school or high school/GED education; no AAAL; Excellent/very good health; those who were overweight or obese; current smokers; physically inactive; and had no primary care provider. In 2014, groups with low age-standardized prevalence of HCP advice for exercise were the same as in 2002 with the addition of those age 18-44 year old age. In 2002 and 2014, the prevalence of HCP for exercise among adults with arthritis who were physically inactive was 47.2% (CI 44.0-50.4%) and 56.7% (CI 52.3-61.0%), respectively (a20% increase).

Conclusion:

While prevalence rates of HCP advice for exercise have increased over more than a decade, there are still groups with high need that have persistently low prevalence. Incorporating prompts into electronic medical records and written exercise prescriptions are potential strategies that may lead to increased prevalence of HCP advice for exercise.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/are-adults-with-arthritis-advised-to-exercise-by-their-health-care-providers-national-health-interview-survey-2002-and-2014/