In the JournalsPerspective

Black, Latina women with knee OA desire timelier information on therapy options

Darrell J. Gaskin

Latina and African American women with knee osteoarthritis want their primary care physicians to provide more information regarding treatment options, while providers who treat such populations suggest they could benefit from a tutorial on their various options, according to findings published in Arthritis Care & Research.

“Latina and African American women are at higher risk of knee OA but are less likely to receive treatment, especially knee replacement surgery,” Darrell J. Gaskin, PhD, MS, of the Johns Hopkins Bloomberg School of Public Health, told Healio Rheumatology. “As a result, their knee pain is not only painful, but it also reduces their functional status (eg, walking, kneeling, climbing stairs, standing) which impacts their ability to work and earn a living.”

To assess whether Latina and African American women with arthritis-related knee pain, as well as primary care providers who serve such populations, feel that their treatment decisions could benefit from additional information regarding impact on quality of life, cost and work productivity, Gaskin and colleagues conducted a series of six focus groups. All focus groups were conducted within the Baltimore area between September 2015 and May 2017. Patients were eligible for the study if they were women aged 45 years or older with knee pain lasting more than 3 months.

 
Latina and African American women with knee OA want their primary care physicians to provide more information regarding treatment options, according to findings.
Source: Adobe

Four focus groups included nine African American and 12 Latina women, recruited through local newspaper advertisements and physician referral. The Latina-focused session was conducted in Spanish. The two provider-centered focus groups included three internists, two family practitioners, one physician’s assistant, one orthopedic surgeon and seven nurse practitioners, all recruited from flyers sent to Johns Hopkins Community Physicians and advertisements in the Nurse Practitioner Association of Maryland newsletter.

Participants were asked their opinions regarding a decision tool that compared a range of treatment options and also provided information on cost as well as their impact on quality of life and productivity. In addition, they were asked whether this information could improve treatment decisions. Patient participants received a $25 gift card, while providers received a dinner at a Baltimore restaurant.

According to the researchers, patients and providers alike endorsed the use of a decision-making tool. However, although the providers agreed patients would benefit from the additional information included in the tool, they expressed concern about its complexity and some patients’ ability to “comprehend the information,” the researchers wrote.

Latina and African American women want to know about the treatment options available to them, and would prefer this information earlier in progression of their arthritis,” Gaskin said. “They want to know to implications of different treatment options beyond its impact on pain. In particular, its potential effect on their quality of life and ability to work and earn a living.”

Regarding cost, patient participants were particularly interested in potential of lost work productivity and income.

“Physicians and surgeons should arrange for their patients to discuss the various treatment options and their impact on women’s pain, functional status and ability to work,” Gaskin said. “Patients would find information session about treatments for knee pain with medical staff useful in making informed treatment decisions.” – by Jason Laday

Disclosures : Darrell reports no relevant financial disclosures. Please see the full study for additional authors’ disclosures.

Darrell J. Gaskin

Latina and African American women with knee osteoarthritis want their primary care physicians to provide more information regarding treatment options, while providers who treat such populations suggest they could benefit from a tutorial on their various options, according to findings published in Arthritis Care & Research.

“Latina and African American women are at higher risk of knee OA but are less likely to receive treatment, especially knee replacement surgery,” Darrell J. Gaskin, PhD, MS, of the Johns Hopkins Bloomberg School of Public Health, told Healio Rheumatology. “As a result, their knee pain is not only painful, but it also reduces their functional status (eg, walking, kneeling, climbing stairs, standing) which impacts their ability to work and earn a living.”

To assess whether Latina and African American women with arthritis-related knee pain, as well as primary care providers who serve such populations, feel that their treatment decisions could benefit from additional information regarding impact on quality of life, cost and work productivity, Gaskin and colleagues conducted a series of six focus groups. All focus groups were conducted within the Baltimore area between September 2015 and May 2017. Patients were eligible for the study if they were women aged 45 years or older with knee pain lasting more than 3 months.

 
Latina and African American women with knee OA want their primary care physicians to provide more information regarding treatment options, according to findings.
Source: Adobe

Four focus groups included nine African American and 12 Latina women, recruited through local newspaper advertisements and physician referral. The Latina-focused session was conducted in Spanish. The two provider-centered focus groups included three internists, two family practitioners, one physician’s assistant, one orthopedic surgeon and seven nurse practitioners, all recruited from flyers sent to Johns Hopkins Community Physicians and advertisements in the Nurse Practitioner Association of Maryland newsletter.

Participants were asked their opinions regarding a decision tool that compared a range of treatment options and also provided information on cost as well as their impact on quality of life and productivity. In addition, they were asked whether this information could improve treatment decisions. Patient participants received a $25 gift card, while providers received a dinner at a Baltimore restaurant.

According to the researchers, patients and providers alike endorsed the use of a decision-making tool. However, although the providers agreed patients would benefit from the additional information included in the tool, they expressed concern about its complexity and some patients’ ability to “comprehend the information,” the researchers wrote.

Latina and African American women want to know about the treatment options available to them, and would prefer this information earlier in progression of their arthritis,” Gaskin said. “They want to know to implications of different treatment options beyond its impact on pain. In particular, its potential effect on their quality of life and ability to work and earn a living.”

Regarding cost, patient participants were particularly interested in potential of lost work productivity and income.

“Physicians and surgeons should arrange for their patients to discuss the various treatment options and their impact on women’s pain, functional status and ability to work,” Gaskin said. “Patients would find information session about treatments for knee pain with medical staff useful in making informed treatment decisions.” – by Jason Laday

Disclosures : Darrell reports no relevant financial disclosures. Please see the full study for additional authors’ disclosures.

    Perspective
    Vickie L. Sayles

    Vickie L. Sayles

    In a recent study conducted by Gaskin et al, it was determined that Latino and African American women with knee osteoarthritis felt that they would benefit from having additional information about the impact of treatment on their quality of life, medical costs and work productivity.

    For rheumatology providers, the information from this study indicates that easy-to-read, understandable and detailed information concerning treatment options, the cost of treatment over the long term, and benefits to their quality of life should be discussed with patients experiencing knee pain due to osteoarthritis.

    While it is difficult to discuss all of this information with patients in a short office visit, shared medical appointments (SMAs) would give providers the time to educate several patients at a time and provide the type of detailed information they seek. Additionally, with an SMA, patients are allowed to ask questions of their providers and interact and seek advice from others experiencing the same problems. Providers also benefit from SMAs by increasing productivity and access and providing higher-quality care to several individuals at one time.

    • Vickie L. Sayles, BSN, CRNI, RN-BC
    • Treasurer, Rheumatology Nurses Society
      Clinical nurse manager
      Department of Rheumatic and Immunologic Diseases
      The Cleveland Clinic Foundation

    Disclosures: Sayles reports speaking fees from Kevzara and Sanofi Genzyme.