In the management of osteoarthritis of the knee, American doctors are more focused on prescribing medication for inflammation or pain than on prescribing physiotherapy and lifestyle counseling. A trend criticized in a recent study.
Physiotherapy and an adapted lifestyle represent better management of knee osteoarthritis than prescription pain medication. This is highlighted by a study published in Arthritis Care & Research. Researchers reviewed 2,297 consultations for knee osteoarthritis drawn from a national database that provided insight into US physicians’ recommendations for treating this condition.
The primary objective of the study was to describe and compare physician recommendations for physical therapy (PT), lifestyle counseling, and pain medication for knee osteoarthritis with recommendations from processing. To this end, the research team conducted a cross-sectional analysis of data between 2007 and 2015 from the National Ambulatory Medical Care Survey.
Decline in physiotherapy prescriptions
The researchers examined the associations between patient, physician and practice factors, as well as the treatment prescribed and concluded that there had been, over the years, a decline in physiotherapy and coping prescriptions. lifestyle, suggesting that these modes of knee OA management remained underutilized, while the use of pain medications increased over the study period.
According to lead author Samannaaz Khoja, an assistant professor of physical therapy research in the department of physical therapy at the University of Pittsburgh School of Health and Rehabilitation, patients with knee osteoarthritis have been found not to receive care. optimal for this disease: the study revealed that the main objective of doctors was to help patients manage their pain by prescribing nonsteroidal anti-inflammatory drugs and narcotics (or opioids). “However, it is also important to consider the long-term benefits of exercise in mitigating decline in physical health,” emphasizes Samannaaz Khoja.
A “worrying” increase in drug prescriptions
The study indicates that despite being part of clinical practice guidelines, physiotherapy prescriptions are still very much in the minority and it calls for further research to determine the barriers to these prescriptions. Dr. Khaja also points out that “the increase in the number of prescriptions for opioid-containing drugs is concerning”.
For visits to orthopedic surgeons, recommendation rates for physical therapy and lifestyle decreased from 2007 to 2015, while prescriptions for nonsteroidal anti-inflammatory drugs and narcotics (or opioids) increased. For consultations with general practitioners, there was no significant change in the rates of physical therapy and lifestyle recommendation or prescription of narcotics, while the number of prescriptions for non-inflammatory anti-inflammatory drugs steroids increased.
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