Nov 18, 1997

Comparison of general internists, family physicians, and rheumatologists managing patients with symptoms of osteoarthritis of the knee

Arthritis Care and Research : the Official Journal of the Arthritis Health Professions Association
Steven A MazzucaG Eckert


To evaluate the nature, risks, and benefits of osteoarthritis (OA) management by primary care physicians and rheumatologists. Subjects were 419 patients followed for symptoms of knee OA by either a specialist in family medicine (FM) or general internal medicine (GIM) or by a rheumatologist (RH). Management practices were characterized by in-home documentation by a visiting nurse of drugs taken to relieve OA pain or to prevent gastrointestinal side effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and by patient report (self-administered survey) of nonpharmacologic treatments. Changes in outcomes (knee pain and physical function) over 6 months were measured with the Western Ontario and McMaster Universities Osteoarthritis Index. Patients of RHs were 2-3 years older (P = 0.035) and tended to exhibit greater radiographic severity of OA (P = 0.064) and poorer physical function (P = 0.076) at baseline than the other 2 groups. In all 3 groups, knee pain and physical function improved slightly over 6 months; however, between-group differences were not significant. Compared to drug management of knee pain by FMs or RHs, that by the GIMs was distinguished by greater utilization of acetaminophen and nonacetylated salicylates (P = ...Continue Reading

Mentioned in this Paper

Degenerative Polyarthritis
Analgesics, Anti-Inflammatory
Anti-Inflammatory Agents, Non-Steroidal
Incidence Studies
Family Medicine (Field)
Gastrointestinal Diseases
Knee Joint

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