Decisions, Decisions for Joint Pain Medicine

Osteoarthritis patients take certain factors into account when choosing medicine

(RxWiki News) A number of medicines are available to ease joint pain and swelling from osteoarthritis. What factors go into a patient's choice of treatment?

Patients will take a medicine's side effects, cost and other factors into account when purchasing a medicine, a recently published study found.

Other factors that patients may consider include how often the medicine is taken and how it's taken.

These findings showed that patients could get the full health and economic benefits with osteoarthritis medications if their medicine preferences are addressed, according to the researchers.

"Research your Rx's side effects & costs."

The aim of the study, led by Tracey-Lea Laba, PhD, from the Faculty of Pharmacy at The University of Sydney, Camperdown in Australia, was to see what medication characteristics most influenced osteoarthritis (OA) patients in their decision to use the medications.

The study involved 188 participants who were part of a previous study investigating the effect of certain supplements in people with osteoarthritis in their knees.

The previous study, called the Long-term Evaluation of Glucoasmine Sulfate, tested whether dietary supplements, glucosamine sulfate, and chondroitin (found in cartilage) could limit or reduce knee cartilage loss over a two-year period.

The current study surveyed participants on seven factors specific to osteoarthritis medication, including how well the medicine stopped pain, how often the medicine was taken, how patients took the medicine (called mode of action) and the out-of-pocket costs.

Other factors included the schedule to take the medicines, side effects and the prescription itself. Participants did not know what kind of supplement they were taking.

The researchers found that side effects, mode of action, treatment schedule and out-of-pocket costs significantly affected patients' choice to continue taking a particular medication.

"Pain efficacy, dose frequency, and whether one’s access to the medication was restricted through prescription and place of purchase did not significantly influence medication choice," the researchers wrote in their report. 

The participants were as likely to continue taking a medicine containing sustained-release acetaminophen, which relieves pain, as they were to continue using a medicine with glucosamine.

Glucosamine is naturally found in joint cartilage. The two substances worked equally as pain relievers and in modifying the properties of osteoarthritis, according to the researchers.

The researchers also found that the patients were less likely to continue using a non-steroidal anti-inflammatory drug (NSAID) because of its potential side effects. And the likelihood of continuing to use glucosamine decreased as out-of-pocket costs increased.

"In the context of a clinical trial assessing therapy effectiveness, non-adherence has the potential to derail translation into clinical practice," the researchers wrote. "By recognizing that a component of this health behavior is intentional and subject to rational choices, this study has characterized the complexity of medication-taking decisions for people with symptomatic osteoarthritis that may lead to intentionally non-adherent behavior, identifying the treatment factors driving such decisions."

Understanding the reasons for which patients stop – or never even start – medication therapy is an issue of significant importance, according to Jason Poquette, BPharm, a registered pharmacist and dailyRx Contributing Expert.

He said that pharmaceutical companies, physicians and pharmacists alike are concerned with developing and prescribing treatments that patients can and will comply with.

"By talking with our patients about their medications for osteoarthritis we may be able to alleviate concerns about risk and offer suggestions for managing bothersome side effects, including the possibility of suggesting alternative therapies for patients to discuss with their physicians," Dr. Poquette said. "Helping patients adhere to their prescribed medication will help improve their outcomes – which is the only real measure of our success."

The researchers noted that the findings might be generalizable to other populations, as most participants in the study adhered to the medications.

However, the researchers said that individuals can still form their medication preferences independent of how they actually take the medicine.

The study was published online May 6 in the journal BMC Musculoskeletal Disorders. No competing interests were declared.

Review Date: 
May 12, 2013