Background/Purpose: Knee osteoarthritis (OA) has worse outcome in racial/ethnic minorities, who also have more severe pain, disability and worse outcomes. However, most qualitative studies include primarily Caucasian people with knee OA. Therefore, our objective was to examine patient experience, views and opinions of reasons for why the current knee OA treatments are not working for them in a diverse racial/ethnic group of people.

Methods: Nominal groups were conducted with consecutive clinic patients with knee OA at a medical center, oversampling African Americans. Patients discussed and rank-ordered their concerns.

Results: Fourteen nominal groups with 48 knee OA patients were conducted with mean age, 60.6 years (standard deviation, 9.8) and knee OA duration, 7.8 years (sd, 5.4); 25% were men, and 46% were African American. The most frequently cited highly-ranked concerns, divided into 3 categories as follows:

A. Medication-related: (1) side effects (9 groups); (2) limited efficacy (9 groups); (3) medication not targeting underlying disease; (4) lack of personalized medication use; and (5) temporary benefit;

B. Exercise/Physical therapy related: (1) exacerbation of joint pain (8 groups); (2) difficulty in doing exercises (6 groups); (3) lack of motivation (8 groups); (4) technical challenges/lack of personalized exercise regimens (1 group); (5) cost (3 groups); and

C. Weight loss related (1) difficulty in achieving weight loss (7 groups); (2) motivation (2 groups); and (3) limited efficacy for symptom improvement (1 group).

Conclusion: Participants with knee osteoarthritis, consisting of a diverse racial/ethnic representation, identified several barriers to the effectiveness of current knee OA treatments. This new knowledge provides insights for making the current treatment options potentially more usable and/or more effective. Given the significant consequences of knee OA, limited/no disease-modifying drugs this strategy can potentially improve clinical care and patient outcomes.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/barriers-to-effectiveness-of-non-surgical-treatments-for-knee-osteoarthritis-in-a-diverse-racial-ethnic-population-a-nominal-group-qualitative-study/