Purpose: The main goal in treating knee osteoarthritis (OA) is providing symptom relief, with a continued focus on easing joint pain and enabling mobility, in order for patients to go about daily activity. With the COVID-19 pandemic having impacted healthcare systems and regimes globally, the aim of this study is to understand how treatment management of knee OA patients and prescribing behavior across US healthcare professionals (HCPs) was affected, and how they adapt towards a potential ‘new norm’ in treating this condition. Methods: A cross-sectional chart review survey was conducted in both Q2 2019 and Q2 2020 among US board-certified rheumatologists (rheums), orthopedic surgeons (orthos), primary care physicians with a focus in sports medicine (SM PCPs), and pain specialists, all practicing across hospital and private practices. Recruited from a large access panel, physicians were screened for duration of practice in their specialty (3-50 years) and caseload (35 or more knee OA patients personally managed, at least 10 of which must be classified as moderate-severe). Participants were asked to complete a 3-part online survey: (1) a doctor demographic questionnaire, (2) a perceptual questionnaire, assessing perception of available and upcoming OA therapies, and (3) patient record charts for the next 5 knee OA patients seen following receipt of the survey, capturing demographics and treatment history. Data were analyzed using descriptive statistics. Results: The total number of sampled physicians recruited in this survey with their reported patient totals are stated in Table 1. [Formula presented] When focusing on the current prescription medication reported patients are receiving, oral medications, particularly NSAIDs, are widely used, regardless of the physician specialty. Here we see a directional increase in the proportion of reported patients deriving from sampled primary care SM PCPs from pre-COVID (Q219) to during COVID (Q220) (not statistically significantly different), whilst the same is not true for the other three secondary care sampled specialties, namely rheums, orthos and pain specialists (not statistically significantly different) - see Fig. 1. [Formula presented] [Formula presented] [Formula presented] Conclusions: From the sample surveyed, it appears that primary care SM PCPs adopted their treatment adjustment during COVID-19 pandemic differently, by prescribing more orals while other secondary care physicians (rheums, orthos, pain specialists) focused on injection treatment for longer pain relief. Considering movement restrictions and limited elective surgeries during the pandemic, the lack of targeted treatment options for knee OA has been made more apparent. With a burgeoning pipeline, many of which are targeted therapies, it is hopeful that knee OA treaters will be less reliant on symptom remedies and can readily offer patients’ longer-acting pain relief or disease modifying options to combat joint deterioration.
Understanding prescription behavior across healthcare professionals in treating knee osteoarthritis before and during the 2020 COVID-19 pandemic