The use of conventional and complementary treatments for knee osteoarthritis in the community.
Jordan KM., Sawyer S., Coakley P., Smith HE., Cooper C., Arden NK.
OBJECTIVES: The aim of the survey was to assess the prevalence of clinically diagnosed knee osteoarthritis (OA) in two general practice populations in the Wessex region (practice A: a deprived urban population and practice B: an affluent rural population) and to assess both conventional and complementary therapy use in these two populations. METHODS: All patients over 55 yr with a clinical diagnosis of knee OA, as identified from the practice computerized records, were sent a questionnaire about their knee pain and their use of conventional and complementary treatments. RESULTS: A total of 4566 patients over 55 yr were registered in the two practices. Of these, 828 (18.13%) had a clinical diagnosis of knee OA and 240 (29%) patients were asymptomatic at the time of survey. Physiotherapy was under-utilized with only 13.1% of patients having received either hospital- or GP-based physiotherapy. There was a high prevalence of non-steroidal anti-inflammatory drug (NSAID) use, being significantly more in the affluent population (P < 0.05). In the affluent population there were statistically more social class groups 1-3a; statistically more NSAIDs, glucosamine and chondroitin sulphate were also used. The median amount spent on complementary medicine per month was 5.00 UK pounds, with the affluent population spending significantly more (P < 0.05). CONCLUSIONS: In this population, physiotherapy is an under-utilized treatment for knee OA, in spite of its recommendation as first-line treatment in all guidelines. Complementary medicines and therapies are commonly used, particularly in affluent populations.