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Background: Osteoarthritis (OA) burdens individuals and healthcare systems across Europe. With limited curative options, symptom management becomes pivotal, yet underdiagnosis and varied healthcare professional education in OA prevail. The role of individuals in their care and the impact of their willingness, beliefs, and perceived barriers are critical. Objectives: This study aimed to assess the awareness of appropriate OA management practices, the suggested and received care pathway, explore beliefs surrounding OA management, analyse encountered obstacles, and gauge overall satisfaction with OA care in Italy, Sweden, and Russia. These countries represent the Mediterranean, Nordic, and Eastern European regions. Methods: A cross-sectional web-based online survey was conducted in Italy, Sweden, and Russia. We included participants over 40 years, who self-reported hip and/or knee OA. The survey instrument underwent a rigorous development process involving healthcare professionals and patients and comprised five sections. The initial section gathered demographic data. In the second section, participants assessed a list of treatments (Table 1) as "recommended," "optional," or "not recommended," and the percentage correctly identified was calculated. Participants could also answer "I don't know". The third section examined both performed and suggested treatments, and the percentage of treatments falling into these categories was computed. The fourth section gauged participant agreement with statements regarding OA care (Table 2), with percentages of agreement exceeding 70% calculated. The fifth section measured overall satisfaction with OA care using a 0-100 Numerical Rating Scale. Results: A total of 401 participants were surveyed (mean age: 59.7, 78.3% female, 28% Italian, 49% Swedish, and 23% Russian). In Sweden, between the 57% (education programmes) and 72% (weight loss) correctly identified recommended treatments, while in Russia, it spanned from 34% (balance training) to 91% (maintaining a healthy weight), and in Italy, it varied between 35% (balance training) and 73% (weight loss). Awareness of optional treatments differed, with correct identification percentages ranging from 9% (antidepressant drugs) to 47% (oral anti-inflammatory drugs) in Sweden, 15% (opioids) to 38% (topical anti-inflammatory drugs) in Russia, and 11% (antidepressant drugs) to 46% (topical anti-inflammatory drugs) in Italy. For not recommended treatments, correct identification ranged from 8% (Paracetamol) to 26% (homeopathy) in Sweden, 8% (growth factor injections) to 25% (natural therapies) in Russia, and 8% (hyaluronic acid injections) to 34% (homeopathic) in Italy. Respondents frequently selected "I don't know" for optional and not recommended treatments (up to 50-74%). The most suggested/taken treatments were oral anti-inflammatory drugs in Italy (87/81%) and Russia (97/97%) and specific physical exercise in Sweden (84/79%). The study identified consensus (>70% agreement) in perceiving OA treatments as uncertain in Russia and seeking online information for OA care in Russia and Sweden. Consensus on non-surgical treatments was only found in Sweden, emphasising exercise effectiveness for everyone. Russia and Italy believed radiographic findings were necessary before engaging in physical exercise. In Russia, the cost and lack of coverage by the public insurance/healthcare system for exercise were perceived as barriers to exercise adherence. No consensus was found regarding diet barriers. Mean (SD) satisfaction scores were 59.7 (25.0), 47.4 (28.0), and 35.2 (23.9) in Italy, Sweden, and Russia, respectively. Conclusion: Survey participants demonstrated greater awareness of recommended treatments than optional and not-recommended ones. Italy and Russia leaned towards passive treatments, in contrast to Sweden. The findings underscore the need for a comprehensive approach to educating individuals with OA, providing a thorough overview of treatment options (recommended or not) to facilitate shared decision-making with healthcare professionals. REFERENCES: NIL. Acknowledgements: This work was funded by the European Alliance of Associations for Rheumatology (EULAR) through the EULAR Health Professionals in Rheumatology (HPR) Research Grant 2020. Disclosure of Interests: None declared.
Battista et al. (Sat,) studied this question.