Older Osteoarthritis Patients Not Happy With Alternative Therapy

June 29, 2005 – Older osteoarthritis suffers, facing the loss and dangers of pain-killing drugs, are turning to alternative therapy but are not happy with the results, according to a recent survey for the National Council on Aging. It also found 87 percent rank their joint pain and stiffness among the top five least welcome effects of growing old, and it was ranked number one most frequently from a list of nine choices.

The survey investigated the profound transformation in treatment trends among OA sufferers, finding that more than two in five (43 percent) of those who have previously used prescription medications have stopped using them. In addition, millions of OA sufferers are dissatisfied with their current treatments and are possibly under-treating or not treating their joint pain, according to the survey.

Compared to one year ago, higher percentages of OA patients aged 50-65 are pursuing other treatment options, such as relaxation techniques, physical therapy and herbs/natural remedies.

However, they also feel their joint pain is less controlled (16 percent reported their pain was “not very controlled” in 2004 vs. 24 percent in 2005) and are more likely to report that their OA is severe (26 percent reported severe joint pain in 2004 vs. 35 percent in 2005). Three in four (75 percent) patients are interested in more aggressive treatments for their OA.

The NCOA says the research “revealed surprising findings on the serious effects joint pain and stiffness caused by osteoarthritis (OA) have on the everyday lives and overall health of the millions of Americans with the debilitating disease.”

Conducted on behalf of NCOA by Harris Interactive, the survey found that respondents who gained weight due to their OA reported an average weight gain of 42 pounds since their diagnosis, which can be attributed in large part to their inability to exercise as much as desired - a feeling expressed by 75 percent of all respondents.

	Additional Findings
	From a list of nine effects of growing old, 87 percent ranked their joint pain and stiffness among the top five least welcome; joint pain and stiffness was ranked #1 most frequently. More than half (53 percent) believe OA has had a moderately or severely negative impact on their lives. 41 percent watch more TV because of pain caused by OA. 35 percent have avoided long car rides because of OA; 32 percent have chosen not to take a trip. 33 percent have chosen not to go to a store because they could not find parking close to the entrance.Nearly three in five (56 percent) respondents reported gaining weight, and these patients gained an average of 42 pounds since their diagnosis. Nearly two-thirds of all respondents (64 percent) reported they were very or extremely active prior to their diagnosis. Now, only 13 percent of them are very or extremely active. Weight gain and the inability to exercise have significant effects on self-esteem: Of the 56 percent who reported they’ve gained weight as a result of their condition, 82 percent say it negatively affected their self-esteem. Of the three-quarters (75 percent) who reported that they have limited their exercise as a result of their condition, roughly seven in ten (69 percent) reported that it has negatively affected their self-esteem. Three in five (59 percent) respondents reported losing sleep due to their OA, and of those 62 percent reported losing two or more hours of sleep per night. More than half (53 percent) of all respondents believe OA has had a moderately or severely negative impact on their lives. Two in five (41 percent) watch more TV because of pain caused by OA. More than one-third (35 percent) has avoided long car rides because of OA; almost another one-third (32 percent) has chosen not to take a trip. Further, one-third (33 percent) has chosen not to go to a store because there was not parking close to the entrance. The basic activities of everyday life, such as walking, running, housework, and the ability to exercise, are impacted greatly for many OA sufferers. In fact, nearly three in four (72 percent) respondents report being limited in doing everyday or routine things. Among a list of 26 activities, the activities listed most often as very or extremely difficult because of OA are: 1. Exercising to keep fit or lose weight (47 percent) 2. Hiking or cycling outdoors (45 percent) 3. Standing in line (40 percent) 4. Playing sports such as golf or tennis (39 percent) 5. Going up and down stairs (39 percent) 6. Gardening (38 percent) 7. Sitting for long periods of time (31 percent) 8. House cleaning (31 percent) 9. Working (25 percent) 10. Traveling (22 percent) 11. Sleeping (20 percent) 12. Craft hobbies like woodworking or sewing (18 percent) 13. Getting in and out of a car (17 percent) OA Sufferers: Feeling “Old” Before Their Time When respondents were asked to rank their top five concerns about getting older from a list of nine, joint pain and stiffness was ranked #1 most frequently. The ranking follows: 1) Joint pain and stiffness 2) Loss of independence 3) Gaining weight/metabolism slow-down 4) Limited mobility 5) Forgetfulness OA is not a disease that affects only those we perceive as “elderly.” Compared to last year, significantly more patients ages 50-65 are rating their OA as “severe.” In addition, 55 percent of OA sufferers age 18-49 reported that regular movement is difficult and/or limited as a result of their OA. Nearly three in 10 (27 percent) respondents reported feeling old and/or limited most of the time or always because of their osteoarthritis. Profound Changes Underway in How OA Sufferers Treat Their Disease More than two in five (43 percent) of those who have previously used prescription medications have stopped using them. There has been an increase over the course of the past year in OA sufferers age 50-65 who are pursuing other non-operative therapies. Additional therapies include over-the-counter medications (+14 percentage points), relaxation techniques (+17 percentage points), weight loss (+9 percentage points), physical therapy (+9 percentage points), herbs/natural remedies (+8 percentage points) and nutritional supplements (+7 percentage points) Compared to one year ago, a higher percentage of OA patients age 50-65 feel their joint pain is less controlled (16 percent reported their pain was “not very controlled” in 2004, vs. 24 percent in 2005), and they are more likely to report that their OA is severe (26 percent reported severe OA in 2004 vs. 35 percent in 2005). Three in four (75 percent) patients are interested in more aggressive treatments for their OA. When asked how much respondents felt they knew about joint replacement surgery, almost three in five (59 percent) reported knowing very little.

Further, 82 percent of those who gained weight reported a decrease in self-esteem due to the weight gain.

Loss of sleep, which can take a serious toll on personal and professional relationships, productivity, and public safety, was identified in the survey as another negative consequence of OA, with 37 percent of sufferers reporting two or more hours of sleep lost per night due to pain caused by OA.

“The results of this study confirm just how serious the effects of joint pain and stiffness are for the more than 20 million Americans who suffer from OA, making clear the need to educate OA sufferers about their options,” said James Firman, president and CEO of NCOA.

NCOA Starts Patient Education Campaign to Help Fill the Information Gap

Given the clear and immediate need to provide OA sufferers with more information regarding the effective treatment of their joint pain and immobility, NCOA is partnering with the National Association of Orthopaedic Nurses (NAON) and DePuy Orthopaedics, Inc. to roll out a comprehensive patient awareness campaign that aims to responsibly educate OA sufferers about the full range of treatment options, including joint replacement, which can help relieve pain and improve function for patients with OA.

“Educational efforts such as this continue to be an important part of NCOA’s mission,” said Mr. Firman. “The negative effects of OA highlighted in the survey released today represent a serious health concern that must be addressed if we are to help improve the health, independence, and overall quality of life of older Americans.”

Patient events held at senior centers throughout the country will feature unique and engaging educational tools developed in collaboration with orthopaedic surgeons to provide OA sufferers with the information they need about the progressive nature of the disease and the treatments available to them.

A custom-designed board game will foster learning, dialogue, and a sense of community, allowing attendees to gain a greater understanding of OA as well as the benefits of various treatments. In addition, a screening video will guide attendees through a series of movements, such as walking, driving, gardening, and golfing to help them identify their level of pain and immobility, so that they can initiate productive conversations with their doctor about treating the disease.

At each event, a physician, a nurse specialist, and an OA sufferer who has benefited from joint replacement will be on hand to answer attendees’ questions and provide additional information.

For more information about OA, sufferers can also access the campaign resources at 1-888-273-9029 or www.jointpainoptions.com.

Joint Replacement Alternatives

“As the Baby Boomer generation ages, many Americans will experience joint pain and loss of mobility caused by OA. In fact, by age 50, most Americans will have clinical and/or radiographic signs of OA,” said Dr. William Healy, chairman of the Department of Orthopaedic Surgery at the Lahey Clinic in Burlington, Mass.

“Given this, it’s important for patients to understand the degree of their pain and immobility and discuss the disease with their doctor, so that he or she can present them with appropriate treatment options. While non-operative treatment is very important during the early stages of arthritis, at some point, the benefit of medication and other therapies may diminish. When that happens, joint replacement can help alleviate pain and restore mobility,” he said.

For those with severe OA who are no longer achieving pain relief from over-the-counter drugs, prescription medications, or other non-surgical treatments, joint replacement offers an alternative. The procedure, which is conducted on approximately 662,000 people in the United States each year, involves removing damaged joint surfaces and resurfacing them with metal and plastic implants. After joint replacement, patients can resume routine movements of everyday life, such as climbing stairs, tying shoes, and getting up from a chair. Improved technology and implant designs have revolutionized joint replacements, allowing for natural movement of the joint after surgery.

The performance of joint replacements depends on age, weight, activity level, and other factors. There are potential risks, and recovery takes time. People with current infections or conditions limiting rehabilitation should not have this surgery. The patient may experience implant complications such as loosening, fracturing, or wearing of the components, which could result in pain, stiffness, or dislocation of the joint. Only an orthopaedic surgeon can tell if joint replacement is right for the patient.

Survey Methodology

Harris Interactive conducted the survey online between April 6 and 14, 2005, on behalf of NCOA, with funding provided by DePuy Orthopaedics, Inc., among a nationwide cross section of 1,000 U.S. adults (aged 18 and over) who have been diagnosed with OA. The sample was recruited to align with quotas established according to the age and gender proportions of OA sufferers indicated in the National Center for Health Statistics/National Health and Nutrition Examination Survey (NHANES). A similar survey was conducted in 2004 of 531 OA sufferers aged 50-65. The margin of error for comparing the two surveys is between +/- 7-9 percent.

Though this online sample is not a probability sample, in theory, with probability samples of this size, Harris Interactive estimates with 95 percent certainty that the results for the overall sample have a sampling error of plus or minus 3 percentage points. Sampling error for the following sub-sample results: those aged 50-65 (397) and those who have gained weight due to their OA (556) is higher and varies.

About The National Council on the Aging

Founded in 1950, The National Council on the Aging is a national network of organizations and individuals dedicated to improving the health and independence of older persons, and to increasing their continuing contributions to communities, society, and future generations. For more information on NCOA, visit www.ncoa.org. The NCOA president and CEO is James Firman.

About The National Association of Orthopaedic Surgeons

The National Association of Orthopaedic Nurses (NAON) was established in 1980 to promote education and research related to nursing care of persons with orthopaedic conditions. Today, NAON is one of the premier national nursing associations of over 6,000 registered and licensed practical/vocational nurses representing all 50 states and several foreign countries. NAON's mission is to advance the quality of musculoskeletal health care by promoting excellence in research, education and nursing practice. For more information on NAON, visit www.orthonurse.org or call 1-800-289-6266 or email naon@orthonurse.org.

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