247340 Racial differences in pain management approaches in patients with osteoarthritis

Monday, October 31, 2011: 12:54 PM

Shibing Yang, MS PhD candidate , Deparment of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, VA
Rachel Jawahar , 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: Osteoarthritis (OA), one of the most common musculoskeletal disorders, has no known cure at present. Limited studies show inconsistent evidence about racial differences in pain management in these patients. Methods: Using data from the Osteoarthritis Initiative, we identified 2,075 non-Hispanic Whites and 508 African-Americans with radiographic tibiofemoral knee OA in at least one knee. Information on CAM therapies (including alternative medical systems, mind-body interventions, manipulation and body-based methods, energy therapies, and 3 types of biologically based therapies) and conventional medication (prescription and OTC NSAIDs, acetaminophen, opioids and doxycycline) were collected by trained interviewers. Polytomous logistic regression was applied to estimate the association between race and treatment approaches after controlling potential confounders. Results: Generally, non-Hispanic Whites used CAM more commonly than African-Americans to alleviate symptoms (48.0% versus 41.5%). Non-Hispanic Whites used more biologically based supplements (35.4% versus 17.9%) and manipulation and body-based methods (6.1% versus 1.4%), while African-Americans used more topical agents (23.2% versus 10.7%). African-Americans used more conventional medication than non-Hispanic Whites (49.8% versus 38.4%). After adjusting for potential confounders, African-Americans were less likely than non-Hispanic Whites to use CAM therapies either alone (OR: 0.71; 95% CI: 0.51-1.00) or in combination with conventional medication (OR: 0.54; 95% CI: 0.38-0.76). Conclusion: Both CAM and conventional medication are commonly used for pain management in OA patients; however, use of these therapies varies by racial group. Some CAMs may be effective; others may interact with conventional medications. Further studies are necessary to determine the effects of different pain management approaches.

Learning Areas:
Chronic disease management and prevention

Learning Objectives:
Describe pain management strategies in non-Hispanic White and African-American adults with radiographic confirmed knee OA.

Keywords: Alternative Medicine/Therapies, Ethnicity

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? Yes

Name of Organization Clinical/Research Area Type of relationship
Pfizer chiropractic health Consultant and grant recipient

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.