The use of conventional and complementary treatments for knee osteoarthritis in the community.

OBJECTIVES The aim of the survey was to assess the prevalence of clinically diagnosed knee osteoarthritis (OA) in two general practice populations in the Wessex region (practice A: a deprived urban population and practice B: an affluent rural population) and to assess both conventional and complementary therapy use in these two populations. METHODS All patients over 55 yr with a clinical diagnosis of knee OA, as identified from the practice computerized records, were sent a questionnaire about their knee pain and their use of conventional and complementary treatments. RESULTS A total of 4566 patients over 55 yr were registered in the two practices. Of these, 828 (18.13%) had a clinical diagnosis of knee OA and 240 (29%) patients were asymptomatic at the time of survey. Physiotherapy was under-utilized with only 13.1% of patients having received either hospital- or GP-based physiotherapy. There was a high prevalence of non-steroidal anti-inflammatory drug (NSAID) use, being significantly more in the affluent population (P < 0.05). In the affluent population there were statistically more social class groups 1-3a; statistically more NSAIDs, glucosamine and chondroitin sulphate were also used. The median amount spent on complementary medicine per month was 5.00 UK pounds, with the affluent population spending significantly more (P < 0.05). CONCLUSIONS In this population, physiotherapy is an under-utilized treatment for knee OA, in spite of its recommendation as first-line treatment in all guidelines. Complementary medicines and therapies are commonly used, particularly in affluent populations.

[1]  K. Pavelka,et al.  Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. , 2002, Archives of internal medicine.

[2]  J. Harwood,et al.  Effects of n-3 fatty acids on cartilage metabolism , 2002, Proceedings of the Nutrition Society.

[3]  T. Schnitzer,et al.  Recommendations for the Medical Management of Osteoarthrits of the Hip and Knee , 2002 .

[4]  R. McCarney,et al.  Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care , 2001, Annals of the rheumatic diseases.

[5]  Eric Lejeune,et al.  Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial , 2001, The Lancet.

[6]  D. Luff,et al.  'Getting somewhere', feeling cared for: patients' perspectives on complementary therapies in the NHS. , 2000, Complementary therapies in medicine.

[7]  C. Cooper,et al.  EULAR recommendations for the management of knee osteoarthritis , 2001 .

[8]  C. Cooper,et al.  Medical management of osteoarthritis , 2000, BMJ : British Medical Journal.

[9]  D. Felson,et al.  Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. , 2000, JAMA.

[10]  C. Cooper,et al.  Regular review: medical management of osteoarthritis. , 2000, BMJ.

[11]  B. Sibbald,et al.  Efficacy of cod liver oil as an adjunct to non-steroidal anti-inflammatory drug treatment in the management of osteoarthritis in general practice. , 1992, Annals of the rheumatic diseases.

[12]  Surveys.,et al.  Standard occupational classification , 1990 .