- •Osteoarthritis is the most common form of arthritis, affecting a high proportion of the elderly population in the US.
- •Recent clinical studies have provided promising data supporting the use of natural products as supplements for treating osteoarthritis.
- •This cross-sectional study based on consumer research data showed that individuals with osteoarthritis have a high body mass index and rates of comorbid diseases and do not exercise on a regular basis.
- •Individuals with osteoarthritis using chondroitin with or without glucosamine were more likely to report use of over-the-counter products only or to use them combined with prescription products.
- •The likelihood of using prescription products increased with the length of osteoarthritis history, highlighting new opportunities for nonsurgical management.
Osteoarthritis (OA) is a frequently occurring, chronic condition; however, few studies describe the clinical characteristics of individuals with OA and the treatments they use to manage their symptoms. We conducted a study to characterize the OA population in the US and describe the nonsurgical management used by this population based on consumer research data collected through an online survey.
Data from the 2017 US National Health and Wellness Survey (NHWS) for adults aged ≥35 years were used to evaluate the relationship between OA and certain study participant characteristics and to identify the most commonly used treatment options. NHWS data were collected through a survey of individuals drawn from the internet panel maintained by Lightspeed Research (Bridgewater, New Jersey) and its panel partners. Weighted estimates were generated using data from the 2016 Current Population Survey (Annual Demographics File) of the US Census Bureau. Comparisons between the general and OA populations were made based on body mass index (BMI), exercise frequency, and comorbid diagnoses of hypertension or diabetes. Among the OA population, the use of dietary supplements, prescription or over-the-counter (OTC) treatments with chondroitin with or without glucosamine (Ch ± Gl), prescription treatment by time since OA diagnosis, and utilization of a physical therapist were also recorded.
The prevalence of OA in the overall population was 17.6 % and was higher for individuals with a BMI ≥ 25 (21.9 %), patients diagnosed with hypertension or diabetes (36.2 %), and those who did not exercise regularly (19.0 %). Adults without OA were more likely to exercise regularly (12 days per month or more) than adults diagnosed with OA. Ch ± Gl (6.0 %) was the most commonly used OTC dietary supplement in the OA population, followed by omega-3 fatty acids (2.8 %), vitamin D (1.9 %), calcium (1.1 %), and multivitamins (0.7 %). Individuals using Ch ± Gl were more likely to use OTC only products (75.4 % vs 37.3 %) or prescription medications, namely non-steroidal anti-inflammatory drugs (NSAIDs) and/or opioids, and OTC products (24.6 % vs 13.0 %) compared with individuals not using Ch ± Gl, while individuals not using Ch ± Gl were more likely to be untreated (30.3 % vs 0) or to use prescription medications only (19.4 % vs 0). Nearly 32 % of individuals with OA reported using prescription treatments, and the likelihood of using a prescription treatment increased with number of years since OA diagnosis (<3 years: 27.5 %; ≥21 years: 32.5 %). The pharmaceutical products used by this population primarily consisted of nonsteroidal anti-inflammatory drugs, acetaminophen and opioids. Approximately 13 % of patients with OA had visited a physical therapist in the past 6 months.
The prevalence of OA was higher in those with a high BMI, and comorbid diabetes or hypertension. Individuals with OA using Ch ± Gl primarily reported use of OTC products only or used them in combination with prescription products. The likelihood of using prescription products increased with the length of OA history. These data provide valuable new information about demographics, clinical characteristics, and commonly used prescription and OTC treatments and dietary supplements in the OA population.
Abbreviations:BMI (body mass index), CAM (complementary and alternative medicine), Ch±Gl (chondroitin with/without glucosamine), M (million), NHANES (National Health and Nutrition Examination Survey), NHIS (US National Health Interview Survey), NHWS (US National Health and Wellness Survey), NSAID (nonsteroidal anti-inflammatory drug), OA (osteoarthritis), OAI (Osteoarthritis Initiative), OARSI (Osteoarthritis Research Society International), OTC (over-the-counter), PRIMO (Patient and PRovider Interventions for Managing OA in Primary Care), PT (physical therapist), Rx (prescription), SCS (stepped-care strategy), y (years of age)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Maturitas
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The epidemiology and impact of pain in osteoarthritis.Osteoarthr. Cartil. 2013; 21: 1145-1153https://doi.org/10.1016/j.joca.2013.03.018
- Epidemiology and burden of osteoarthritis.Br. Med. Bull. 2013; 105: 185-199https://doi.org/10.1093/bmb/lds038
- The symptoms of osteoarthritis and the genesis of pain.Rheum. Dis. Clin. North Am. 2008; 34: 623-643https://doi.org/10.1016/j.rdc.2008.05.004
- Economic and humanistic burden of osteoarthritis: a systematic review of large sample studies.Pharmacoeconomics. 2016; 34: 1087-1100https://doi.org/10.1007/s40273-016-0424-x
- Vital signs: prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation - United States, 2013-2015.MMWR Morb. Mortal. Wkly. Rep. 2017; 66: 246-253https://doi.org/10.15585/mmwr.mm6609e1
- Updated estimates suggest a much higher prevalence of arthritis in United States adults than previous ones.. 2018; 70: 185-192https://doi.org/10.1002/art.40355
- Ageing and the pathogenesis of osteoarthritis.Nat. Rev. Rheumatol. 2016; 12: 412-420https://doi.org/10.1038/nrrheum.2016.65
- The age-related changes in cartilage and osteoarthritis.Biomed Res. Int. 2013; 2013916530https://doi.org/10.1155/2013/916530
- 2019 American College of Rheumatology/Arthritis foundation guideline for the management of osteoarthritis of the hand, hip, and knee.Arthritis Rheumatol. 2020; 72: 220-233
- OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.Osteoarthr. Cartil. 2019; https://doi.org/10.1016/j.joca.2019.06.011
- Natural products for promoting joint health and managing osteoarthritis.Curr. Rheumatol. Rep. 2018; 20: 72https://doi.org/10.1007/s11926-018-0782-9
- What is the evidence for a role for diet and nutrition in osteoarthritis?.Rheumatology. 2018; 57: iv61-iv74
- Diet, nutrition and osteoarthritis.Am. J. Lifestyle Med. 2007; 1: 260-263https://doi.org/10.1177/1559827607302033
- Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis.Br. J. Sports Med. 2018; 52: 167-175https://doi.org/10.1136/bjsports-2016-097333
- Emerging trend in the pharmacotherapy of osteoarthritis.Front Endocrinol (Lausanne). 2019; 10: 431https://doi.org/10.3389/fendo.2019.00431
- Clinic variation in recruitment metrics, patient characteristics and treatment use in a randomized clinical trial of osteoarthritis management.BMC Musculoskelet. Disord. 2014; 15: 413https://doi.org/10.1186/1471-2474-15-413
- Geographic variations in arthritis prevalence, health-related characteristics, and management - United States, 2015.Surveill. Summ. 2018; 67: 1-28https://doi.org/10.15585/mmwr.ss6704a1
- Leisure time physical activity among U.S. Adults with arthritis, 2008-2015.Am. J. Prev. Med. 2017; 53: 345-354https://doi.org/10.1016/j.amepre.2017.03.017
- Are older adults with symptomatic knee osteoarthritis less active than the general population? Analysis from the Osteoarthritis Initiative and the National Health and Nutrition Examination Survey.Arthritis Care Res (Hoboken). 2018; 70: 1448-1454https://doi.org/10.1002/acr.23511
- How do people with knee osteoarthritis use osteoarthritis pain medications and does this change over time? Data from the Osteoarthritis Initiative.Arthritis Res. Ther. 2013; 15: R106https://doi.org/10.1186/ar4286
- Medication and supplement use for managing joint symptoms among patients with knee and hip osteoarthritis: a cross-sectional study.BMC Musculoskelet. Disord. 2012; 13: 47https://doi.org/10.1186/1471-2474-13-47
- Use of complementary and alternative medicine among patients with radiographic-confirmed knee osteoarthritis.Osteoarthr. Cartil. 2012; 20: 22-28https://doi.org/10.1016/j.joca.2011.10.005
- Health care use of patients with osteoarthritis of the hip or knee after implementation of a stepped-care strategy: an observational study.Arthritis Care Res (Hoboken). 2014; 66: 817-827https://doi.org/10.1002/acr.22222
- Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis.Osteoarthr. Cartil. 2015; 23: 507-515https://doi.org/10.1016/j.joca.2014.11.019
- Factors that may mediate the relationship between physical activity and the risk for developing knee osteoarthritis.Arthritis Res. Ther. 2008; 10: 203https://doi.org/10.1186/ar2343
- Empirical evidence of recall bias for primary health care visits.BMC Health Serv. Res. 2015; 15: 381https://doi.org/10.1186/s12913-015-1039-1
Published online: December 04, 2020
Accepted: December 3, 2020
Received in revised form: November 9, 2020
Received: April 15, 2020
© 2020 Elsevier B.V. All rights reserved.