title: Preference for nonsteroidal antiinflammatory drugs versus acetaminophen and concomitant use of both types of drugs in patients with osteoarthritis.
abstract: OBJECTIVE
  To analyze results of treatment of osteoarthritis (OA) with acetaminophen and the nonsteroidal antiinflammatory drugs (NSAID) through a patient survey.
  
  
  METHODS
  A 15 minute telephone survey was conducted with 300 patients, including 172 with confirmed OA.
  
  
  RESULTS
  Twenty-four percent of patients who took acetaminophen rated it as "very helpful," compared to 31% for ibuprofen, 30% for naproxen, and 56% for diclofenac. Drug continuation beyond 24 months was reported by 33% of patients for acetaminophen, 21% for ibuprofen, 17% for naproxen, and 19% for diclofenac. Acetaminophen was significantly less likely to be discontinued because of toxicity than NSAID. Patients who indicated that they would not take a drug again, and therefore be unlikely to participate in a clinical trial involving this drug, were 26% for acetaminophen, 40% for ibuprofen, 38% for naproxen, and 28% for diclofenac. About 30% of patients who took acetaminophen reported concurrent use of ibuprofen, naproxen, or diclofenac. Among the 67% of patients who identified a drug as "most helpful," 80% named an NSAID, compared to 20% who named acetaminophen or another analgesic as the "most helpful" drug.
  
  
  CONCLUSIONS
  Patients take many different drugs for OA, most of which are not continued beyond 2 years. Many patients take both acetaminophen and an NSAID. Most patients who identified a drug as "most helpful" named an NSAID rather than acetaminophen or an analgesic drug. These findings may be of value in further development of management strategies and guidelines for OA.
authors.affiliation: Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. theodore.pincus@vanderbilt.edu
authors.forename: T
authors.initials: T
authors.lastname: Pincus
authors.forename: C
authors.initials: C
authors.lastname: Swearingen
authors.forename: P
authors.initials: P
authors.lastname: Cummins
authors.forename: L F
authors.initials: LF
authors.lastname: Callahan
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003625:Data Collection; D004008:Diclofenac / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D008297:Male; D009288:Naproxen / Q000627:therapeutic use; D010003:Osteoarthritis / Q000188:drug therapy*; D017060:Patient Satisfaction; D012646:Self Administration; D011795:Surveys and Questionnaires
chemical_list: D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D000082:Acetaminophen; D009288:Naproxen; D007052:Ibuprofen