Care for knee osteoarthritis in the United States
A new study published in Arthritis Care & Researchprovides an overview of U.S. physicians’ recommendations for physical therapy, lifestyle counseling, pain medications for treating knee osteoarthritis.
The study examined 2,297 physician visits for knee osteoarthritis from a National Database. For visits to orthopedists, physical therapy and lifestyle recommendation rates declined from 2007 to 2015, while prescriptions for nonsteroidal anti-inflammatory drugs and narcotics (or opioids) increased. Among visits to primary care physicians, there were no significant changes in rates of physical therapy and lifestyle recommendation or narcotics prescriptions, while prescriptions for nonsteroidal anti-inflammatory drugs increased.
“Our major takeaway from this research is that patients might not be receiving optimum care for knee osteoarthritis. Physicians seem more focused on helping their patients manage their pain with medications, but it is also important to consider the long-term benefits of exercise for mitigating declines in physical health,” said lead author Samannaaz Khoja, PT, PhD, Research Assistant Professor at the University of Pittsburgh School of Health and Rehabilitation Sciences’ Department of Physical Therapy. “Despite being part of clinical practice guidelines, exercise-based interventions are still being prescribed at a very low rate. More research is needed to determine barriers to prescribing exercise.” Dr. Khaja noted that although the observed increase in non-narcotic medication would be expected as part of standard treatment protocols, the rise in narcotic prescriptions is concerning and warrants attention.
Samannaaz S. Khoja, Gustavo J. Almeida, Janet K. Freburger. Recommendation Rates for Physical Therapy, Lifestyle Counseling and Pain Medications for Managing Knee Osteoarthritis in Ambulatory Care Settings. Cross‐sectional Analysis of the National Ambulatory Care Survey (2007‐2015). Arthritis Care & Research, 2019; DOI: 10.1002/acr.24064