What drives osteoarthritis patients to use or not use NSAIDS, paracetamol and complementary medications?

Aim: To explore the key motivators behind osteoarthritis (OA) patients’ use/
non-use of non-steroidal anti-infl ammatory drugs (NSAIDs), paracetamol
and complementary medications (CMs).

Methods: A qualitative study, in which in-depth semi-structured interviews
were conducted with 15 OA patients, recruited from four general practices
in Sydney, Australia. Patients were aged 65 or above, and were currently
taking, or had recently taken, an NSAID for osteoarthritis. Coding of the
data involved line-by-line analysis, synthesis of codes into categories, and
abstraction of categories into concepts. Throughout, a process of constant
comparison was used.
Results: Two key themes emerged from the rich data: attachment and
routine. Attachment: Patients were strongly attached to their NSAID because
it consistently worked well for them. They were much less attached to para-
cetamol because of uncertainty or scepticism about its effectiveness. They
were also less attached to CMs but were willing to take them indefi nitely
because they were perceived as harmless. Routine: Many patients took their
NSAID, as well as CMs routinely. In contrast, patients had diffi culty develop-
ing a routine around paracetamol use at the recommended maximum dose
because of various fears about taking six/eight tablets a day.
Conclusions: Our results highlight the complexity behind non-adherence
to clinical practice guidelines on OA, and the need for general practitioners
and specialists to delve deeper into individual motivations when developing
management plans with patients.