title: Medication and supplement use for managing joint symptoms among patients with knee and hip osteoarthritis: a cross-sectional study.
abstract: BACKGROUND
  The purpose was to determine the professionally-guided and self-guided medication and supplement use for joint symptom management among patients with knee and/or hip osteoarthritis (OA) in an urban hospital-based outpatient orthopedic practice.
  
  
  METHODS
  The study design was cross-sectional. Patients diagnosed by radiographs and clinical symptoms with knee and/or hip OA were recruited from an inner-city hospital-based outpatient orthopaedic office. A total of 184 patients were queried for their participation. Four investigator-generated, interview-based questionnaires were used. Sampling error was ±7.84%. Logistic regression models and Fisher Exact Tests were performed to determine factors that may be associated with negative behaviors related to medication or supplement use (e.g., reporting medication as ineffective, using multiple medications in the same day to manage symptoms). Odds ratios (OR) and 95% confidence intervals (CI) were calculated for significant findings.
  
  
  RESULTS
  Among the 162 participants, a majority reported professionally-guided recommendations and over 40% reported at least one self-guided intervention. 37 participants reported dual-use during the same day, and among those,15 reported dual-use at the same time. Among participants taking multiple interventions in the same day, 40.5% reported using prescription and over-the-counter medications. Use of multiple medications or supplements in one day was more common among participants who reported OA at multiple joints (OR [95% CI]=2.48 [1.03 to 5.96]) but less common among participants who did not complete high school (OR [95% CI]=0.26 [0.08 to 0.83]). Of the 15 participants who reported dual-use at the same time, 11 were professionally-guided, 5 were professional and self-guided, and 1 was solely self-guided. Overall, 28% of participants reported their intervention as ineffective, sought an alternative method to achieve symptomatic relief, or were prescribed a stronger medication. Participants who reported not always taking their medication consistently for 2 weeks were more likely to report their medication as ineffective (OR [95% CI]=2.87 [1.19 to 6.92]).
  
  
  CONCLUSIONS
  Both professional and self-guided medications and supplements are used by inner city OA patients to manage their joint symptoms. It is important for clinicians to discuss with these patients how to effectively manage multiple joint symptoms, the importance of taking medications as prescribed, and what they should if they believe a treatment is ineffective or their medication runs out.
authors.affiliation: Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA 02111, USA. jdriban@tuftsmedicalcenter.org
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Driban
authors.forename: Sara A
authors.initials: SA
authors.lastname: Boehret
authors.forename: Easwaran
authors.initials: E
authors.lastname: Balasubramanian
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Cattano
authors.forename: Joseph
authors.initials: J
authors.lastname: Glutting
authors.forename: Michael R
authors.initials: MR
authors.lastname: Sitler
mesh_terms: D000368:Aged; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000009:adverse effects; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006621:Hip Joint / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D007407:Interviews as Topic; D007719:Knee Joint / Q000187:drug effects* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D016017:Odds Ratio; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D010044:Outpatient Clinics, Hospital; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D015143:Philadelphia; D012651:Self Medication; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014504:Urban Health
chemical_list: D000700:Analgesics; D000893:Anti-Inflammatory Agents; D004366:Nonprescription Drugs