In the JournalsPerspective

More than half of arthritis patients aged 45 or older untreated

Kristina Theis, PhD
Kristina Theis

More than 50% of adults aged 45 years or older with some form of arthritis are currently going untreated, despite a substantial proportion experiencing severe symptoms and poor physical function, according to data published in the Journal of Clinical Rheumatology.

“Arthritis is treatable, but people need to be connected to clinical and public health systems to benefit from available treatments,” Kristina Theis, PhD, of the CDC Arthritis Program, told Healio Rheumatology. “More than half of adults aged 45 or older with doctor-diagnosed arthritis are not currently being treated for it. Very poor quality-of-life, daily joint pain, limited function and arthritis-attributable symptoms were common among those with no current treatment.”

To better understand adults with diagnosed cases of arthritis who do not receive treatment, Theis and colleagues obtained data from the Arthritis Conditions Health Effects Survey (ACHES), a cross-sectional, random-digit-dialed national telephone poll. The survey — funded and designed by the CDC, and executed through an agreement with the Battelle Center for Public Health Research in 2005 to 2006 — aimed to collect information on noninstitutionalized adults aged 45 and older with self-reported or physician-diagnosed arthritis or chronic joint symptoms.

The ACHES poll collected demographic information, as well as data on symptoms, physical functioning, arthritis limitations and interference in life activities, treatment, level of agreement with treatment, attitude knowledge and behavior. A total of 1,793 participants were identified as individuals with arthritis.

According to the researchers, 52% of the participants with arthritis were going untreated. Among those not receiving treatment, 59% said they had two or more symptomatic joints, 51% reported daily arthritis pain and 40% reported they were being limited by their condition. In addition, 19% of those going untreated reported being in the lowest third of physical functioning. Despite failing to receive treatment, 83% agreed or strongly agreed it was important to see a health care professional for diagnosis and treatment.

“Adults with arthritis can benefit greatly from medical management, referrals to self-management education and community-delivered interventions,” Theis said. “Non-rheumatology health care providers already seeing patients with diagnosed arthritis are ideally placed to begin arthritis treatment and provide referrals to specialists, community-delivered interventions and arthritis-specific care.” – by Jason Laday

Disclosure: Theis reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Kristina Theis, PhD
Kristina Theis

More than 50% of adults aged 45 years or older with some form of arthritis are currently going untreated, despite a substantial proportion experiencing severe symptoms and poor physical function, according to data published in the Journal of Clinical Rheumatology.

“Arthritis is treatable, but people need to be connected to clinical and public health systems to benefit from available treatments,” Kristina Theis, PhD, of the CDC Arthritis Program, told Healio Rheumatology. “More than half of adults aged 45 or older with doctor-diagnosed arthritis are not currently being treated for it. Very poor quality-of-life, daily joint pain, limited function and arthritis-attributable symptoms were common among those with no current treatment.”

To better understand adults with diagnosed cases of arthritis who do not receive treatment, Theis and colleagues obtained data from the Arthritis Conditions Health Effects Survey (ACHES), a cross-sectional, random-digit-dialed national telephone poll. The survey — funded and designed by the CDC, and executed through an agreement with the Battelle Center for Public Health Research in 2005 to 2006 — aimed to collect information on noninstitutionalized adults aged 45 and older with self-reported or physician-diagnosed arthritis or chronic joint symptoms.

The ACHES poll collected demographic information, as well as data on symptoms, physical functioning, arthritis limitations and interference in life activities, treatment, level of agreement with treatment, attitude knowledge and behavior. A total of 1,793 participants were identified as individuals with arthritis.

According to the researchers, 52% of the participants with arthritis were going untreated. Among those not receiving treatment, 59% said they had two or more symptomatic joints, 51% reported daily arthritis pain and 40% reported they were being limited by their condition. In addition, 19% of those going untreated reported being in the lowest third of physical functioning. Despite failing to receive treatment, 83% agreed or strongly agreed it was important to see a health care professional for diagnosis and treatment.

“Adults with arthritis can benefit greatly from medical management, referrals to self-management education and community-delivered interventions,” Theis said. “Non-rheumatology health care providers already seeing patients with diagnosed arthritis are ideally placed to begin arthritis treatment and provide referrals to specialists, community-delivered interventions and arthritis-specific care.” – by Jason Laday

Disclosure: Theis reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

    Perspective
    Carrie Beach

    Carrie Beach

    The study conducted by Theis and colleagues revealed a lack of patient-initiated treatment options for adults aged 45 years and older diagnosed with “arthritis” by a health care professional. Adults were asked via phone questionnaire if they had ever been told by a health care provider (HCP) that they had some form of arthritis, including osteoarthritis, gout, lupus, and fibromyalgia. Additional questions included whether they were on treatment; had experienced joint pain, stiffness or arthritis-related fatigue over the past 7 days; the number of joints affected; limitations to physical function and overall health status.

    Interestingly, more than half of the individuals diagnosed with arthritis by an HCP were on no current therapy (NCT) and a significant number of those respondents reported current severe symptoms, arthritis-related limitations and poor physical function. A great majority of NCT respondents agreed it is important to see an HCP for diagnosis and treatment.

    So why aren’t these patients seeking treatment from an HCP? One could theorize lack of access to care; however, the largest population of NCT in the study were older than 65 years making this theory unlikely due to access to Medicare. This study suggests a common misconception among older adults that arthritis is simply a normal part of aging, therefore seeking treatment may not be helpful.

    It is important as HCPs that we do not minimalize a patient’s symptoms according to age. Yes, arthritis is very common, but associated pain and disability is neither necessarily normal nor inevitable. Another reason may simply lie with how one defines treatment: 54% of NCT respondents reported taking medication in the past 7 days for arthritis but didn’t consider that an actual treatment. Perhaps these respondents are looking beyond medications to treat arthritis symptoms.

    This is a very important lesson to HCPs: We need to consider non-pharmacological treatments like stretching/range of motion exercises, physical and occupational therapy, yoga and self-management education. While there are several limitations to this study, we can all appreciate the need to better educate patients regarding treatment options and expectations for living with arthritis.

    • Carrie Beach, BSN, RN
    • Historian, Rheumatology Nurses Society
      Nursing education coordinator
      Columbus Arthritis Center

    Disclosures: Beach reports no relevant financial disclosures.