Background/Purpose: Knee osteoarthritis (KOA) is a leading global cause of disability and chronic pain (Cross et al., 2014). It is well established that KOA affects individuals differently (Kohn et al., 2016) and there has been a shift towards adopting a more patient-centric approach to treatment (Kolasinski et al., 2019; NICE, 2022). Understanding patient and physician preferences for KOA pain relief treatment remains critical for guiding new treatments appraisals and facilitating treatment decisions. This qualitative study sought to understand what aspects of (primarily pharmacological) pain relief treatments are most important to patients and physicians. The findings will inform the design of a discrete choice experiment.

Methods: Semi-structured interviews were conducted with patients and physicians in six countries (FR, DE, IT, ES, UK, and US). Patients were eligible if they regularly experienced moderate-to-severe pain associated with KOA and had been prescribed pain relief treatment. Physicians were eligible if they treated >25 patients per month; medical specialities reflected clinical practice in each country.

Results: We conducted 72 interviews comprising 48 patients and 24 physicians (n=2 orthopaedists per country, n=2 rheumatologists in all but DE and US, n=1 general surgeon in DE, n=1 interventional pain specialist in US). Physician approaches to KOA pain management were similar across countries and specialities. Physicians’ typical approach to pain management involved consideration the patients’ overall health, comorbidities, weight, usual activities, and ability to engage in physiotherapy. Among patients, the most important benefits were pain relief itself, improvement in function, and the ability to go about their usual activities. Many patients also felt that sufficient pain relief gives them peace of mind and has positive effects on their mood and mental health. Delaying the need for knee replacement surgery or avoiding surgery altogether was considered a potential benefit of pain relief treatment by both patients and physicians. However, physicians caveated that this depends on the patient’s general health state and current levels of pain management. Physicians tended to be more aware of potential side effects compared to patients. Views on the preferred mode of administration were mixed within and across groups: some patients felt that being able to take treatment themselves was important, while others did not think the mode of administration was important. Views on intra-articular injections were also mixed, but patients were generally open to try injections if their pain was no longer managed sufficiently. Those patients with previous experience of intra-articular injections were likely to have had a positive experience.

Conclusion:  Patient and physician preferences and priorities are broadly aligned in terms of the benefits of pain relief treatments. However, due to individual variation, individuals’ preferences regarding mode of administration and clinical profile need to be considered when making treatment decisions.

« Back to ACR Convergence 2024

ACR Meeting Abstracts - https://acrabstracts.org/abstract/patient-and-physician-preferences-for-pain-relief-treatment-for-moderate-to-severe-pain-associated-with-knee-osteoarthritis-a-qualitative-exploration/