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• W3153606438 abstract "Purpose: To relieve pain and other disabling symptoms of osteoarthritis (OA), total joint replacement is an effective approach primarily performed when other treatment options have been exhausted. The objective of this study was to assess physicians’ perspectives on surgical treatment for OA within US practice settings. Methods: Data were collected using the OA Adelphi Disease Specific Programme, a cross-sectional survey including 81 (52.9%) primary care physicians (PCPs), 35 (22.9%) rheumatologists, and 37 (24.2%) orthopedic surgeons, conducted in the US from February to May 2017. Physician specialties were compared based on practice-level questions regarding their perspectives on surgery (surgical recommendations, barriers patients face when considering surgery, perceived surgical success rates, and reasons for delaying surgery) using chi-square and analysis of variance tests. Results: Physicians were predominantly male (72.5%), with private (84.8%) and office/outpatient (87.3%) practices and had been practicing for ≥15 years (77.8%). More than half (56.8%) of orthopedic surgeons agreed that the general treatment aim was to delay surgery whereas 30.9% of PCPs and 25.7% of rheumatologists agreed (p=0.0224). Post-surgical treatment regimens by orthopedic surgeons, rheumatologists, and PCPs included no change from pre-surgery regimen (respectively, 22.5%;33.0%;24.0%), no/delayed chronic OA medication use (64.6%;47.6%;62.0%), or new/revised regimen (12.9%;19.4%;14.1%). Patient satisfaction with surgery perceived by physicians varied by specialty with 83.8%, 68.6% and 60.5% of orthopedic surgeons, rheumatologists, and PCPs respectively agreeing that most patients were very satisfied (p<0.001). Outcomes of surgery perceived by physicians (orthopedic surgeons, rheumatologists, and PCPs) varied by specialty (all p<0.001) including the proportion of patients completely pain free after hip surgery (respectively, 86.8%;79.9%;66.6%), and completely pain free after knee surgery (81.7%;72.3%;67.0%). Yet how physicians rated success with surgery did not differ by specialty with improved function and pain reduction as the top two descriptors of success (Figure 1). Overall, the main physician-reported triggers to recommend surgery were ‘lack of mobility’ (68.0%), ‘degree of pain on movement’ (45.8%), and ‘failure to control condition with drug treatment’ (35.3%). The main barriers to surgery were comorbid conditions (86.9%) and surgical risk (83.7%) (Figure 2). Orthopedic surgeons rated other barriers lower than PCPs and rheumatologists such as patient refusal (respectively, 51.4%;71.6%;71.4%), age (43.2%;72.8%;62.9%) and costs (21.6%;37.0%;34.3%). Conclusions: Delaying surgery was a key goal for more orthopedic surgeons than PCPs and rheumatologists when treating patients with OA. Orthopedic surgeons perceived that more patients were satisfied and completely pain free after surgery than those of PCPs and rheumatologists. Compared with orthopedic surgeons, PCPs rated patient refusal, age and cost as greater barriers to surgical procedures. Data are limited in that not all specialties that treat patients with OA were included and further physician inclusion could be influenced by willingness to take part in the study. Yet understanding specialty-related variability in perceptions of surgical care may warrant further exploration as it may have implications for broadening training, referrals, and management practices across specialties in an effort to optimize care for patients with OA.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Disclosures: The study was conducted by Adelphi Real World and sponsored by Pfizer and Eli Lilly and Company . Medical writing support was provided by Kim Russell of Engage Scientific Solutions and funded by Pfizer and Eli Lilly and Company ." @default.
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• W3153606438 date "2021-04-01" @default.
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• W3153606438 title "Physicians’ perspectives on surgical procedures related to osteoarthritis in the United States" @default.
• W3153606438 doi "https://doi.org/10.1016/j.joca.2021.02.307" @default.
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