Osteoarthritis and Cartilage Open (Mar 2023)

Evaluation of disease burden, patient journey, unmet diagnosis and treatment needs of patients with HIP and knee osteoarthritis in Turkey: A study through Delphi Methodology

  • Hasan Fatih Çay,
  • Ayşen Akıncı,
  • Lale Altan,
  • Şebnem Ataman,
  • Semih Aydoğdu,
  • Demirhan Dıraçoğlu,
  • Hakan Genç,
  • Simin Hepgüler,
  • Ayşegül Ketenci,
  • Kadriye Öneş,
  • Meltem Uyar,
  • Salih Gümrü,
  • Başak Hacıbedel,
  • Kerem Helvacıoğlu,
  • Ayşe Ölmez,
  • Tiraje Tuncer

Journal volume & issue
Vol. 5, no. 1
p. 100332

Abstract

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Objective: To get information-driven insights from expert physicians regarding multiple aspects of the patient journey in knee and hip OA and establish a consensus for future studies and decision tree models in Turkey. Design: 157 questions were asked in total during this three-round modified Delphi-method panel to 10 physical medicine and rehabilitation specialists (2 have rheumatology and 3 have algology subspeciality), one orthopaedic surgeon and one algology specialist from anaesthesia specialty background. A consensus was achieved when 80% of the panel members agreed with an item. Contradictions between different disciplines were accepted as a non-consensus factor. Results: Panellists agreed that American College of Rheumatology classification criteria is mostly sufficient to provide an OA diagnosis in clinical practice, OA patients with ≥5 Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain or physical function score can be defined as moderate-to-severe OA if they have an additional ≥2 Kellgren-Lawrence (KL) score, a minimum improvement of 30% from baseline in WOMAC pain or function subscales or in PGA score can be accepted as moderate treatment response where ≥50% improvement from baseline in those scores as substantial response. Panellists stated that arthroplasty procedures need to be delayed as long as possible, but this delay should not jeopardize a beneficial and successful operation. Conclusions: These findings show that there is a significant disease burden, unmet treatment needs for patients with moderate-to-severe OA in Turkey from experts’ perspective. Therefore, an updated systematic approach and decision tree models are needed to be implemented.

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