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Group Seeks Refinement of Knee Arthritis Treatment Guidelines

Changes should stress education, patient activity management interventions, review finds

MONDAY, Dec. 10 (HealthDay News) -- Six sets of guidelines for the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of knee osteoarthritis (OA) published or updated between 2001 and 2006 contain differences and a lack of educational information, according to a review published in the online journal Arthritis Research & Therapy.

The guidelines were meant to address concerns over cardiovascular risks associated with NSAIDs.

The review was conducted by an international team of 13 clinical researchers, including rheumatologists, physiotherapists, occupational health experts and general practitioners. They used the Appraisal of Guidelines Research and Evaluation (AGREE) criteria to evaluate the guidelines.

The guidelines recommend acetaminophen for initial pain treatment, combined with exercise and education. If this fails to control pain, NSAIDs are the next option but should be used cautiously due to gastrointestinal (GI) risks. Surgery may be required for persistent pain and disability.

The reviewers said most of the guidelines discuss education and patient activity management interventions superficially, and they recommend that future guidelines should contain more detail about these aspects.

The reviewers also found the guidelines effectively addressed only a few of AGREE criteria.

"To improve applicability and increase uptake by end users, stakeholder opinions and barriers in use need to be taken into account during guideline development," the reviewers wrote.

They noted that guideline development and dissemination of new knowledge are slow processes and recommended development of innovative methods of providing new knowledge to health professionals.

More information

The American Academy of Family Physicians has more about knee OA.

-- Robert Preidt

SOURCE: Arthritis Research & Therapy, Dec. 6, 2007

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