After Pharmacists Identify Patients With Undiagnosed Osteoarthritis, Patients Make Self-Care Decisions on Their Own
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What happens after community pharmacists identify patients as having undiagnosed osteoarthritis of the knee?
In one recent longitudinal study, the answer was: the patients make several lifestyle interventions and see improvements in their pain and function. However, they tend to make these changes without the advice of a health professional, and usually without any ongoing pharmacist care.
The current study was a follow-up assessment of a pilot program that investigated whether community pharmacists could reliably identify people with undiagnosed knee osteoarthritis using a simple screening questionnaire. Of the 194 people identified, 190 were confirmed by physical examination and radiographs to have osteoarthritis. These participants were asked to provide information about self-management interventions (exercise, analgesic medications, treatment/aids, and natural medicine supplements) and the people who recommended them (e.g., physician, family member, physiotherapist) at 1, 3, and 6 months post-diagnosis.
By month 6, participants reported the following treatment interventions:
• 75% claimed to participate in routine aerobic, strength, or endurance exercises (e.g., walking, biking).
• 52% of participants started analgesic therapy, with half of patients reporting use of NSAIDs.
• 36% started natural medicine supplementation with glucosamine alone or glucosamine plus chondroitin.
• 33% used activity aids such as acupuncture, knee tape, knee braces, and shoe inserts.
• 8% completed the 6-week Arthritis Self-Management Program (12 hours total).
Most (93%) of the participants also had visited their primary care practitioner to discuss their osteoarthritis.
More than half of the participants stated that they decided to start exercising, using activity aids, or taking analgesic medication on their own. Pharmacists were credited with providing advice in only two instances: once for analgesic medications and once for glucosamine.
The authors found the limited ongoing involvement of pharmacists in patient care to be “unexpected,” given that the study introduced the pharmacist as the first point of contact for participants. The authors cited the large number of participants starting analgesic therapy with NSAIDs prior to an appropriate trial of acetaminophen as evidence of the need for pharmacist input.
Arthritis Care Res. 2010;62:510-15.