What Patients Do Following a New Diagnosis of Knee Osteoarthritis
Bibliographic record
Abstract
Objective To describe patient use of health services and products within 6 months of a new diagnosis of knee OA. Methods Patients with knee pain and no previous diagnosis of knee OA were recruited by community pharmacists using a simple questionnaire to determine the likelihood of knee OA. In total, 194 participants considered likely to have knee OA were referred to a rheumatologist for a standardized knee exam and radiograph. Of these, 190 were confirmed to have knee OA and were subsequently followed for a period of 6 months. At baseline, 1, 3 and 6 months, a survey was administered that contained questions designed to elicit information on participants' health service and product use. Categories included pain-relieving medication, exercise (e.g., walking), treatments/aids (e.g., knee taping/brace, acupuncture, Arthritis Society Management Program, shoe inserts) and supplements (e.g., glucosamine). In addition, to assess participant satisfaction with pharmacy services, participants were asked to rate their levels of agreement with 4 statements using a five-point Likert scale. Results Follow-up data for all 3 time points were available for 124 (65%) participants. Of these, 64% were female, the mean age was 63 years and 67% were considered either obese or overweight according to their body mass index (BMI). By 6 months, 93% had visited their primary care practitioner for OA, 74% had initiated exercise, 59% had started supplements, 51% had taken pain-relieving medications and 45% had used activity aids. When asked “who gave you this advice,” the majority of participants stated “on my own” for all categories. This was followed by “family physician” for all categories except supplements, which were recommended by “family/friend” 20% of the time. Participants selected “pharmacist” least frequently in all categories, including for the initiation of pain-relieving medication, where only 2% reported a pharmacist recommendation. Of those taking pain-relieving medications, 49% took NSAIDs, 28% took acetaminophen and 12% took a combination of both. The majority of participants were very satisfied with the pharmacy services received (>90%) and few reported any complaints (>10%). While 18% of participants thought that pharmacy services could be better, only 17% thought that pharmacy services were just about perfect. Conclusion Following a diagnosis of knee OA, the majority of participants sought out an intervention, the most popular being exercise and natural medicine supplements. Despite the initial diagnosis by a pharmacist and self-reported satisfaction with pharmacy services, few participants attributed interventions to pharmacists. Even with recent evidence showing that pharmacist involvement can reduce potentially dangerous NSAIDs use in knee OA, most participants appeared to make lifestyle changes independent of health professional advice, and pharmacists played a very small role in this. These results suggest that more work is needed to expand the role of pharmacists toward chronic disease management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".