Treatment Adherence in Osteoarthritis – A Pilot Study

Approximately 51% of Ontario residents aged 75+ suffer from osteoarthritis (OA) with women twice as likely as men to be affected by the disease. While there is no cure for OA, there are drug and lifestyle treatments that can effectively reduce pain and improve physical functioning. Failure to adhere to treatment recommendations means that individuals are achieving sub-optimal pain relief, leading to significant costs to their families and the Canadian health care system. The purpose of this study was to explore the experience of adherence to prescribed treatments, particularly pain medication, in older adults with disabling hip and knee OA.

Eighteen adults (10 females, 8 males) aged 65+ were interviewed to discuss their experiences with prescribed painkillers for OA. We found that adherence to pain medication differed to that of other prescribed medications. Participants were reluctant to take painkillers, and when they did, generally took them at a lower dose or frequency than prescribed. Extensive rationalization for this behaviour was provided. Perceptions and attitudes to pain played an integral role in participants’ adherence to painkillers. These findings suggest that re-evaluation of the prescription of pain medication for OA is warranted and that the effectiveness of pain management in OA needs to account for adherence behaviour in older adults.

Investigators

Gillian Hawker (PI), Joanna Sale (post-doctoral project), Monique Gignac

Funding

Orthopaedic and Arthritic Institute

Date

2003
  • Sale JEM, Gignac M, Hawker GA. How “bad” does the pain have to be? A qualitative study examining adherence to pain medication in older adults with osteoarthritis. Arthritis Rheum. 2006; 55:272-8.
  • Sale JEM, Hawker GA. Adherence to pain medication in adults with osteoarthritis: A qualitative study. Poster presentation at the CAN Annual Scientific Conference, October 29-31, 2005.
  • Sale JEM, Hawker GA. Adherence to pain medication in adults with osteoarthritis. (Oral) 11th Qualitative Health Research Conference in Utrecht, The Netherlands, 11-14 May 2005.
  • Sale JEM, Hawker GA. Experiences of treatment adherence in osteoarthritis. (Oral) 10th International Qualitative Health Research Conference. Banff, Alberta. 30 April-4 May 2004.