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. 2024 Oct 18;12(20):2077.
doi: 10.3390/healthcare12202077.

Pain Management in Knee Osteoarthritis: Insights from an Exploratory Online Survey of Italian Patients and Physicians

Giovanni Iolascon  1 , Alberto Migliore  2 , Giovanna Beretta  3 , Andrea Bernetti  4 , Roberto Bortolotti  5 , Antonella Celano  6 , Antonino Giarratano  7   8 , Franco Marinangeli  9 , Alberto Momoli  10 , Gian Domenico Sebastiani  11 , Andrea Tomasini  6 , Silvia Tonolo  12 , Fabiana Madotto  13 , Alberto Di Martino  14   15 , Silvia Natoli  16   17
Affiliations

Pain Management in Knee Osteoarthritis: Insights from an Exploratory Online Survey of Italian Patients and Physicians

Giovanni Iolascon et al. Healthcare (Basel). .

Abstract

Background: In Italy, knee osteoarthritis (KOA) accounts for over 5 million prevalent cases and requires long-term multidisciplinary management. The most frequent KOA symptom is pain. The aim of the survey is to provide a national overview of the current management of moderate-to-severe pain associated with KOA from both clinicians' and patients' perspectives.

Methods: An exploratory qualitative survey was conducted in Italy between July and October 2023. The survey participants were members of four national scientific societies and two patient associations who were invited to participate via email and given an online questionnaire. Questions included a mix of single and multiple responses and scalar items.

Results: In total, 1473 clinicians and 150 patients with KOA completed the questionnaire. Patients rated knee pain as both the most burdensome symptom and the most frequent reason for treatment dissatisfaction and seeking consultation. One in two patients declared that they were unsatisfied/little satisfied with the current prescribed analgesic treatments. The clinicians surveyed preferentially prescribed intra-articular hyaluronic acid, oral non-steroidal anti-inflammatory drugs/paracetamol, non-pharmacological intervention, and intra-articular corticosteroids. The clinicians' selection of analgesic therapy often failed to adequately meet patients' expectations for pain relief.

Conclusions: Our findings highlight the current unmet needs of patients with KOA in Italy and call for new approaches to effectively optimize the management of KOA-associated pain.

Keywords: knee; osteoarthritis; osteoarthritis management; pain; patient perspective; qualitative research.

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Conflict of interest statement

S.N. received an honorarium as a speaker directly or indirectly from Grünenthal Italia, Molteni. A.G., F.M. (Franco Marinangeli), G.B., A.B., A.M., G.D.S., R.B., S.T., A.C., A.T., G.I., A.M. (Alberto Migliore), A.D.M. and F.M. (Fabiana Madotto) declare no conflicts of interest. The authors declare that this study received funding from Grunenthal Italia S.r.l. and SERF. The sponsor was not involved in any of the stages from study design to submission of the paper for publication.

Figures

Figure 1
Figure 1
Impact of KOA symptoms (panel A) and associated pain (panel B) on patients’ daily life.
Figure 2
Figure 2
Patients’ degree of satisfaction with analgesic therapy and reasons of dissatisfaction as reported by the patients surveyed.
Figure 3
Figure 3
The most frequent analgesic interventions prescribed to patients with KOA with moderate-to-severe pain as reported by the clinicians surveyed who encountered patients for referral. COXIB, cyclo-oxygenase inhibitor; IACS, intra-articular corticosteroids; IAHA, intra-articular hyaluronic acid; NSAIDs, non-steroidal anti-inflammatory drugs; PRP, platelet-rich plasma; SYSADOA, symptomatic slow-acting drugs for osteoarthritis.
Figure 4
Figure 4
Most frequent prescribed analgesic interventions as reported by the clinicians surveyed when managing a patient with moderate-to-severe KOA-associated pain. COXIB, cyclo-oxygenase inhibitor; IACS, intra-articular corticosteroids; IAHA, intra-articular hyaluronic acid; NSAIDs, non-steroidal anti-inflammatory drugs; PRP, platelet-rich plasma; SYSADOA, symptomatic slow-acting drugs for osteoarthritis.
Figure 5
Figure 5
Clinicians’ degree of satisfaction with the pain relief obtained with currently available analgesic interventions. COXIB, cyclo-oxygenase inhibitor; IACS, intra-articular corticosteroids; IAHA, intra-articular hyaluronic acid; NSAIDs, non-steroidal anti-inflammatory drugs; PRP, platelet-rich plasma; SYSADOA, symptomatic slow-acting drugs for osteoarthritis.
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