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Abstract Number: 1451

Use of Analgesics in Patients with Knee and/or Hip Osteoarthritis: Results from the Amsterdam Osteoarthritis Cohort

Joyce van Tunen1, Marike van der Leeden1,2, Martin van der Esch1, Leo D. Roorda1, Willem F. Lems3,4 and Joost Dekker5, 1Amsterdam Rehabilitation Research Center | Reade, Amsterdam, the Netherlands, Amsterdam, Netherlands, 2Rehabilitation Medicine/EMGO, VU University Medical Center, Amsterdam, Netherlands, 3Rheumatology, Jan van Breemen Research Institute | Reade, Amsterdam, the Netherlands, Amsterdam, Netherlands, 4Rheumatology, VU University Medical Center, Amsterdam, Netherlands, 5Rehabilitation Medicine, Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: analgesics, medication, osteoarthritis and pain management

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Session Information

Session Title: Rheumatoid Arthritis - Clinical Aspects (ARHP): Clinical Practice/Patient Care

Session Type: Abstract Submissions (ARHP)

Background/Purpose

Use of analgesics is recommended by international guidelines to reduce pain complaints related to knee and/or hip osteoarthritis. Underuse of analgesics might be substantial in patients with knee and/or hip osteoarthritis due to poor implementation of guidelines. Factors associated with analgesic use are not assessed systematically, although knowledge of the use of analgesics will improve the prescription of analgesics. Therefore, the first aim of this study was to describe the use of analgesics in patients with knee and/or hip osteoarthritis, referred to an outpatient center for rehabilitation and rheumatology in the Netherlands. The second aim was to determine factors that are associated with analgesic use in this population.


Methods

Data from 497 patients with knee and/or hip osteoarthritis according to clinical ACR criteria from the Amsterdam Osteoarthritis cohort were used. Self-reported analgesic use was measured. Independent factors included predisposing (e.g. demographic and social characteristics), enabling (the ability to use care resources, e.g. referring physician) and disease-related (the most immediate cause for analgesic use) factors. Logistic regression analysis was performed to analyze the association between analgesic use and the independent factors.

Results

The mean±SD age of patients was 61,6±9,0 year and 72% were woman. Total scores on pain, stiffness and activity limitations on the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were 43,5±18,1. Analgesic use was reported in 53% of the patients; 37% used acetaminophen, 21% used non-selective non-steroidal anti-inflammatory drugs (NSAIDs), 3% used coxibs and 8% used opioids. Both monotherapy or combinations of analgesics were used. Univariate logistic regression analysis showed that high scores on pain, stiffness and activity limitations on the WOMAC were associated with analgesic use. In addition, gender (women), being overweight or obese, having bilateral knee symptoms, higher levels of psychological distress and a higher amount of comorbidities were associated with analgesic use. Higher levels of psychological distress were associated with the use of acetaminophen. Preliminary results of multivariate logistic regression analysis showed that a higher score on the subscale pain of the WOMAC was associated with analgesic use.

Conclusion

Half of patients with knee and/or hip osteoarthritis referred to an outpatient center for rehabilitation and rheumatology used analgesics. More pain was associated with use of analgesics, suggesting that the analgesics used are not sufficiently effective in reducing symptoms. This may indicate that more effective strategies of pain management need to be implemented.


Disclosure:

J. van Tunen,
None;

M. van der Leeden,
None;

M. van der Esch,
None;

L. D. Roorda,
None;

W. F. Lems,
None;

J. Dekker,
None.

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