Assessment of Compliance of Glucosamine and Chondroitin Sulfate in Patients with Early Osteoarthritis of Knee

The majority of the time, OA is associated with advanced age, and compliance with the protocol is always an issue leading to poor patient satisfaction due to inadequate treatment.Chronic diseases need long-term medication with multiple drugs.This results in poor compliance because of many reasons, namely difficult to understand regimen, high cost of medication, drug interactions, side effects of therapy, poor family support system, elderly population, and forgetfulness.This poor compliance is up to 50% in the general population and ranges from 47 to 90% in the elderly population.7 This raises serious concern, especially in the elderly population, leading to the worsening of the condition.8 IntroductIon Osteoarthritis (OA) is one of the most common geriatric problems, which not only increases the burden on the healthcare system but also hampers the quality of life of the patient. 1 Prevalence of OA of the knee joint is very common in the geriatric population.This condition results from mechanical, metabolic, genetic, and other influences.Manifestation ranges from mild discomfort in the knee to a serious incapacitating condition leading to the inability to perform daily activities.Depending upon the stage of the disease and the lifestyle of the patient, there are various treatment modalities available targeted at pain management, delay of progression of degeneration, and the replacement of the articular surface with the prosthesis [total knee replacement (TKR) surgeries and unicondylar knee replacement (UKR)].Amongst analgesics, the nonsteroidal anti-inflammatory drugs (NSAIDs) are most commonly used to treat pain; however, their indiscriminate use results in gastrointestinal tract as well as renal system side effects, especially in the elderly population.2,3 Due to the side effect profile of NSAIDS, various other pharmacological products have been experimented with s the basic pathology in OA is degeneration of the articular cartilage, glucosamine and chondroitin sulfate were introduced to prevent wear and tear.The articular cartilage of the joint is made up of glycosaminoglycans and proteoglycans, which are formed by glucosamine.Chondroitin is a part of proteoglycans of articular cartilage.Both of them have antiarthritic and anti-inflammatory activities.4,5 A meta-analysis by McAlindon et al. demonstrated pain alleviation in patients with OA after administration of glucosamine and chondroitin sulfate.6 However, it requires a period of prolonged and regular compliance and the combined approach with lifestyle modification as well as supervised physiotherapy.