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2/144 von 416 DIMDI: MEDLINE (ME60) © NLM

ND: | ME15226163
PMID: | 15226163
LR: | 20061115
CED: | 20040630
DCO: | 20040805
Autoren: | Fraenkel L; Bogardus ST Jr; Concato J; Wittink DR
Titel: | Treatment options in knee osteoarthritis: the patient's perspective.
Quelle: | Archives of internal medicine; VOL: 164 (12); p. 1299-304 /20040628/
PM: | Print
SU: | AIM IM
Sprache: | English
CY: | United States
JID: | 0372440
ISSN: | 0003-9926
CO: | AIMDAP
Institution: | Veterans Affairs Connecticut Healthcare System, West Haven, USA. liana.fraenkel@yale.edu
DT: | Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
Schlagwörter
CT: | AGED; ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL/adverse effects; ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL/economics; ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL/therapeutic use; CAPSAICIN/economics; CAPSAICIN/therapeutic use; COSTS AND COST ANALYSIS; CYCLOOXYGENASE INHIBITORS/adverse effects; CYCLOOXYGENASE INHIBITORS/economics; CYCLOOXYGENASE INHIBITORS/therapeutic use; DECISION MAKING; FEMALE; FOLLOW-UP STUDIES; HUMANS; MALE; MIDDLE AGED; OSTEOARTHRITIS, KNEE/*drug therapy; OSTEOARTHRITIS, KNEE/economics; PATIENT SATISFACTION; PEPTIC ULCER/chemically induced; PEPTIC ULCER/epidemiology; RISK FACTORS; TREATMENT OUTCOME
CTG: | ALTE MENSCHEN; ANTIPHLOGISTIKA, NICHTSTEROIDALE/unerwünschte Nebenwirkungen; ANTIPHLOGISTIKA, NICHTSTEROIDALE/Ökonomie; ANTIPHLOGISTIKA, NICHTSTEROIDALE/therapeutische Anwendung; CAPSAICIN/Ökonomie; CAPSAICIN/therapeutische Anwendung; KOSTEN UND KOSTENANALYSE; CYCLOOXYGENASEINHIBITOREN/unerwünschte Nebenwirkungen; CYCLOOXYGENASEINHIBITOREN/Ökonomie; CYCLOOXYGENASEINHIBITOREN/therapeutische Anwendung; ENTSCHEIDUNGSFINDUNG; WEIBLICH; VERLAUFSSTUDIEN; MENSCH; MÄNNLICH; MENSCHEN IM MITTLEREN LEBENSALTER; OSTEOARTHROSE, KNIE/*Arzneimitteltherapie; OSTEOARTHROSE, KNIE/Ökonomie; PATIENTENZUFRIEDENHEIT; ULCUS PEPTICUM/chemisch hervorgerufen; ULCUS PEPTICUM/Epidemiologie; RISIKOFAKTOREN; BEHANDLUNGSERGEBNIS
TE: | Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase Inhibitors; Capsaicin/404-86-4
CR: | 404-86-4
NOTE: | Comment in: Arch Intern Med. 2005 Mar 28;165(6):702; Ref.PMID: 15795352
AB: | BACKGROUND: The objectives of this study were to (1) examine patient treatment preferences for knee osteoarthritis, (2) determine the influence of specific medication characteristics on patients' choices, and (3) examine whether patient preferences are consistent with current practice. METHODS: A total of 100 consecutive patients with symptomatic knee osteoarthritis completed an interactive computer questionnaire administered during a face-to-face interview. We measured the relative impact of specific medication characteristics (including administration, risks, benefits, and cost) on patients' choice, and the percentage of patients preferring nonselective nonsteroidal antiinflammatory drugs (NSAIDs), cyclooxygenase-2 inhibitors, glucosamine and/or chondroitin sulfate, opioid derivatives, and capsaicin across varying risks, benefits, and costs. RESULTS: Of the characteristics studied, variation in the risk of common adverse effects and gastrointestinal ulcer had the greatest impact on patients' choice. Assuming patients are responsible for the full cost of their medications, over 40% prefer capsaicin. Cyclooxygenase-2 inhibitors become patients' preferred choice only if they are described as being 3 times as effective as capsaicin and are covered by insurance. Nonselective NSAIDs are among the least preferred options across all simulations. CONCLUSIONS: When evaluating multiple alternatives, many older patients with knee osteoarthritis are willing to forgo treatment effectiveness for a lower risk of adverse effects. The patient treatment preferences derived in this study conflict with the current widespread use of nonselective NSAIDs in older patients with arthritis.

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