Opioids for Osteoarthritis: Cross-Sectional Survey of Patient Perspectives and Satisfaction

Patients often take opioids to relieve osteoarthritis (OA) pain despite limited benefits and potential harms. This study aimed to compare cross-sectional perspectives of patients that were taking prescription opioid (N = 471) or nonopioid medications (N = 185) for OA in terms of satisfaction, expectations of effectiveness, and concerns. Patients prescribed opioids (>7 days) reported more prior treatments (2.47 vs. 1.74), greater mean pain intensity (5.47 vs. 4.11), and worse quality of life (EQ-5D-5L index value mean 0.45 vs. 0.71) than patients prescribed nonopioid medications (all p < 0.0001). Based on linear regression models adjusting for demographics and pain intensity, patients prescribed opioids were less satisfied with overall regimen (3.40 vs. 3.67, p = 0.0322), had less belief that medications were meeting effectiveness expectations (2.72 vs. 3.13, p < 0.0001), and had more concerns about treatments being “not very good” (3.66 vs. 3.22, p = 0.0026) and addiction (3.30 vs. 2.65, p < 0.0001) than patients prescribed nonopioid regimens. When the models were replicated for subgroups with ≥30 days’ medication regimen duration, the findings were consistent with the main analyses. Patients have concerns about the risk of opioid addiction, but those with greater disease burden and more prior treatments continue taking opioid regimens.

[1]  T. Schnitzer,et al.  Opioid Prescribing for Osteoarthritis: Cross-Sectional Survey among Primary Care Physicians, Rheumatologists, and Orthopaedic Surgeons , 2023, Journal of clinical medicine.

[2]  T. Behl,et al.  Highlighting the Benefits of Rehabilitation Treatments in Hip Osteoarthritis , 2022, Medicina.

[3]  T. Schnitzer,et al.  Satisfaction with Medications Prescribed for Osteoarthritis: A Cross-Sectional Survey of Patients and Their Physicians in the United States , 2022, Pain and Therapy.

[4]  J. Cappelleri,et al.  Concern about addiction is associated with lower quality of life in patients with osteoarthritis: an exploratory, real-world data analysis , 2021, Quality of Life Research.

[5]  D. Malhotra,et al.  Moderate to Severe Osteoarthritis Pain and Its Impact on Patients in the United States: A National Survey , 2021, Journal of pain research.

[6]  R. Buchbinder,et al.  Trends in management of hip and knee osteoarthritis in general practice in Australia over an 11-year window: a nationwide cross-sectional survey , 2021, The Lancet regional health. Western Pacific.

[7]  S. Silverman,et al.  Clinical and economic burden of prescribing tramadol and other opioids for patients with osteoarthritis in a commercially insured population in the United States , 2021, Pain.

[8]  M. Fitzcharles,et al.  Is opioid therapy for chronic non‐cancer pain associated with a greater risk of all‐cause mortality compared to non‐opioid analgesics? A systematic review of propensity score matched observational studies , 2021, European journal of pain.

[9]  J. Cappelleri,et al.  Multimodal Treatment Patterns for Osteoarthritis and Their Relationship to Patient-Reported Pain Severity: A Cross-Sectional Survey in the United States , 2020, Journal of pain research.

[10]  T. Ushida,et al.  Treatment and Healthcare Cost Among Patients with Hip or Knee Osteoarthritis: A Cross-sectional Study Using a Real-world Claims Database in Japan Between 2013 and 2019 , 2020, Clinical Drug Investigation.

[11]  Wenhui Wei,et al.  The Burden of Pain Associated with Osteoarthritis in the Hip or Knee from the Patient’s Perspective: A Multinational Cross-Sectional Study , 2020, Advances in Therapy.

[12]  Raveendhara R. Bannuru,et al.  Is There Any Role for Opioids in the Management of Knee and Hip Osteoarthritis? A Systematic Review and Meta‐Analysis , 2020, Arthritis care & research.

[13]  M. Stokes,et al.  Comorbidities and their link with individual health status: A cross-sectional analysis of 23,892 people with knee and hip osteoarthritis from primary care , 2020, Journal of comorbidity.

[14]  C. A. Jones,et al.  Are Medical Comorbidities Contributing to the Use of Opioid Analgesics in Patients with Knee Osteoarthritis? , 2020, Osteoarthritis and cartilage.

[15]  S. Bierma-Zeinstra,et al.  Opioid prescriptions in patients with osteoarthritis: a population-based cohort study , 2020, Rheumatology.

[16]  G. Guyatt,et al.  2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee , 2020, Arthritis care & research.

[17]  F. Petzke,et al.  Opioids for chronic osteoarthritis pain: An updated systematic review and meta‐analysis of efficacy, tolerability and safety in randomized placebo‐controlled studies of at least 4 weeks double‐blind duration , 2019, European journal of pain.

[18]  E. Jang,et al.  Factors related to the use of opioids as early treatment in patients with knee osteoarthritis , 2019, Arthritis Research & Therapy.

[19]  E. Roos,et al.  Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice. , 2019, Clinical and experimental rheumatology.

[20]  A. Perruccio,et al.  Factors Associated With Opioid Use in Presurgical Knee, Hip, and Spine Osteoarthritis Patients , 2019, Arthritis care & research.

[21]  F. Berenbaum,et al.  The opioid epidemic: helping rheumatologists prevent a crisis , 2019, RMD Open.

[22]  J H Abbott,et al.  OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. , 2019, Osteoarthritis and cartilage.

[23]  P. Franklin,et al.  Association of Geography and Access to Health Care Providers With Long‐Term Prescription Opioid Use in Medicare Patients With Severe Osteoarthritis: A Cohort Study , 2019, Arthritis & rheumatology.

[24]  C. Cooper,et al.  Safety of Opioids in Osteoarthritis: Outcomes of a Systematic Review and Meta-Analysis , 2019, Drugs & Aging.

[25]  T. Muneta,et al.  Treatment satisfaction with pharmaceutical interventions in Japanese adults with osteoarthritis and chronic knee pain: an analysis of a web-based survey , 2018, Clinical interventions in aging.

[26]  J. Callaghan,et al.  Are We Still Prescribing Opioids for Osteoarthritis? , 2017, The Journal of arthroplasty.

[27]  Roger Chou,et al.  CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016. , 2016, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[28]  R. Chou,et al.  CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016. , 2016, JAMA.

[29]  M. Cheatle.  Prescription Opioid Misuse, Abuse, Morbidity, and Mortality: Balancing Effective Pain Management and Safety. , 2015, Pain medicine.

[30]  S. Giménez,et al.  Clinical management of patients with hip and knee osteoarthritis: patient satisfaction with treatment switch , 2014, Rheumatology International.

[31]  R. D. de Bie,et al.  Joint‐pain comorbidity, health status, and medication use in hip and knee osteoarthritis: A cross‐sectional study , 2012, Arthritis care & research.

[32]  G. Bonsel,et al.  Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L) , 2011, Quality of Life Research.

[33]  B. Galer,et al.  Treatment satisfaction in osteoarthritis and chronic low back pain: the role of pain, physical and emotional functioning, sleep, and adverse events. , 2011, The journal of pain : official journal of the American Pain Society.

[34]  V. Welch,et al.  Oral or transdermal opioids for osteoarthritis of the knee or hip. , 2009, The Cochrane database of systematic reviews.

[35]  J. Piercy,et al.  Real-world physician and patient behaviour across countries: Disease-Specific Programmes – a means to understand , 2008, Current medical research and opinion.

[36]  M. Dougados,et al.  EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT) , 2004, Annals of the rheumatic diseases.

[37]  Arden,et al.  EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT) , 2003, Annals of the rheumatic diseases.

[38]  N. Bellamy,et al.  Clinical evaluation of the WOMAC 3.0 OA Index in numeric rating scale format using a computerized touch screen version. , 2002, Osteoarthritis and cartilage.

[39]  Nitin R. Patel,et al.  A Network Algorithm for Performing Fisher's Exact Test in r × c Contingency Tables , 1983 .

[40]  L. Maxwell,et al.  Tramadol for osteoarthritis , 2006 .