How do people with osteoarthritis or low back pain balance benefits and risks when choosing which medications to use for their pain
Full reference: Turk, DC, Boeri, M, Abraham, L, Atkinson, J, Bushmakin, A, Cappelleri, JC, Hauber, B, Klein, K, Russo, L, Viktrup, L, Walsh, DA. Patient Preferences for Osteoarthritis Pain and Chronic Low Back Pain Treatments in the United States: A Discrete-Choice Experiment. Osteoarthritis Cart. 2020, 28, 1202-13. Doi: 10.1016/j.joca.2020.06.006
The full article is available at the Science Direct website.
Anti-inflammatory tablets (such as ibuprofen) and opioids (such as codeine) are often used to treat the chronic pain of osteoarthritis or low back pain. However, pain relief might not outweigh the risk of side effects from such treatments. New injectable treatments are being developed for osteoarthritis pain, but these also may have side effects. In this study 601 people in the USA with osteoarthritis or chronic low back pain filled in an online questionnaire asking how they felt about various features of pain medicines including likely pain relief and risks of associated side effects.
For those who completed the questionnaire, the most important features of a medicine were that it provided good pain relief, had a low risk of addiction and was not too costly. Of the 10 presented risks, stroke, addiction, and heart attack were considered the most important to avoid. Whether the medicine was available as tablets or by injection was less important. Pain relief was considered most important, and people were willing to accept, in exchange for pain relief, a more than 25% risk of addiction, and a more than 0.5% risk of having a heart attack each year.
In conclusion, comparing benefits and different risks is like comparing apples with pears. The preferences of people with osteoarthritis or low back pain should be considered when selecting pain relieving treatments. Clinicians need to explain important benefits and risks to help people to choose their treatment.