Racial differences in analgesic/anti-inflammatory medication use and perceptions of efficacy.

BACKGROUND AND OBJECTIVE: Pharmacotherapy is a key component to osteoarthritis (OA) treatment. Research has shown important racial differences in pain thresholds and perceptions, but little is known about racial variations in responses to pain medications. The purpose of this study was to compare perceptions of efficacy of pain medications among African-American and Caucasian veterans with OA. METHODS: Participants (N = 202; 70% Caucasian, 30% African-American) were under care for OA within the VA healthcare system. Participants rated the helpfulness of current analgesic/anti-inflammatory medications (scale of 1--not at all helpful to 10--very helpful). RESULTS: The mean rating of medication helpfulness was 6.1. African-American participants reported significantly greater ratings of medication helpfulness than Caucasians (6.6 vs. 5.9), controlling for demographics, disease severity, total number of analgesic/anti-inflammatory medications being taken, and the class of the medication. CONCLUSION: African Americans had somewhat more favorable perceptions of medication helpfulness than Caucasians. However, overall ratings of medication helpfulness were relatively low. Further research is needed to examine whether modifiable factors (such as low dosing or patient nonadherence to prescription instructions) contribute to perceptions of poor efficacy.

Use of non-pharmacological therapies among patients with osteoarthritis.

BACKGROUND AND AIMS: Non-pharmacological therapies are an important component of treatment for osteoarthritis (OA), but they may be under-used. This study examined the prevalence of self-reported use of common non-pharmacological therapies, as well as patient and physician-related predictors of use. METHODS: Subjects included 205 veterans who completed a survey regarding OA symptoms and treatments. Analyses examined the prevalence of use of three specific non-pharmacological therapies: exercise, physical therapy (PT), and dietary/herbal supplements. We also examined whether patient variables (demographics, clinical characteristics, and perceived helpfulness of non-pharmacological therapies) and physician characteristics (age, gender, race, and recommendation of non-pharmacological therapies) were associated with use of each therapy. RESULTS: Forty-six percent of subjects reported current use of exercise, 11% reported using PT, and 12%, dietary/herbal supplements. Patient demographic and clinical characteristics were generally poor predictors of use of non-pharmacological therapy. However, females were more likely to report exercising than males (p<0.05), and patients with greater disease severity were more likely to report current use of PT (p<0.001). Patients' perceived helpfulness of each therapy significantly predicted use (p<0.05). Physician demographic characteristics were not strong predictors of patients' use of therapy, but physician recommendation for exercise and PT predicted patients' use (p<0.05). CONCLUSIONS: Among this sample of veterans with OA, there was relatively low use of exercise, PT, and dietary/herbal supplements. Patients' perceptions of treatment helpfulness and physician recommendations strongly predicted use. These results signal the importance of interventions aimed at educating both patients and physicians about these therapies.