244512 Approaches to pain management in women with osteoarthritis

Monday, October 31, 2011

Rachel Jawahar, MPH PhD candidate , Deparment of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA
Shibing Yang, MS PhD candidate , Deparment of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA
Charles B. Eaton, MD , Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, RI
Kate L. Lapane, PhD , Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA
Background: Knee osteoarthritis (OA) increases health care utilization and cost. Women have worse pain and quality of life measures compared to men even after accounting for differences in age, BMI and OA severity. Methods: Using data from the Osteoarthritis Initiative, we identified 2,679 women and men with radiographic tibiofemoral in at least one knee. We classified treatment approaches as current CAM therapy (alternative medical systems, mind-body interventions, manipulation and body-based methods, energy therapies, and 3 types of biologically based therapies) or conventional medication use (OTC or prescription); Gender-specific multivariable logistic regression models identified correlates of CAM use by sociodemographics and clinical/functional factors. Results: CAM use was common (51% women; 41% men). Compared to men, women used more mind-body interventions (14.1% vs. 5.7%), topical agents (16.1% vs. 9.5), and concurrent CAM strategies (18% vs. 9.9%). Increased quality of life measures and physical function indices in women were inversely associated with any therapy, while increased pain scores were positively associated with conventional medication use. History of hip replacement was a strong correlate of conventional medications in women but not men. Multijoint arthritis was associated with increased odds of all treatment: conventional alone (AOR: 2.00;95% CI: 1.36-2.96), CAM alone (AOR: 1.72; 95% CI: 1.25-2.36) or both (AOR: 2.61; 95% CI: 1.83-3.73). Conclusion: Women use CAM more frequently than men and often combine CAM with conventional medication. Clinicians prescribing conventional medications for women with OA of the knee should also consider the effectiveness of combining these treatments with CAM.

Learning Areas:
Chronic disease management and prevention

Learning Objectives:
Describe pain management strategies in women and men with radiographic confirmed knee OA.

Keywords: Alternative Medicine/Therapies, Gender

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Eaton has received grants and has served as a consultant to Pfizer. Dr. Lapane has served as a consultant to Pfizer and Ortho McNeil Johnson.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.