THU0649 Understanding ethnic differences in the utilisation of exercise for osteoarthritis
Authors: E.R. Vina, D. Ran, M.J. Hannon, C.K. Kwoh
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> According to a US survey, the prevalence of arthritis-attributable activity limitation, work limitation and severe pain are all significantly higher among Hispanics than among non-Hispanics (NHs). Ethnic differences in osteoarthritis (OA) patients' experience of pain may be related to marked disparities in the use of OA treatments. According to EULAR OA guidelines, exercise should be an integral part of the management of knee and hip OA. Whether or not exercise is underutilised and why it may be underutilised by Hispanics to treat OA is unclear. <h3>Objectives</h3> The objective of this study was to determine if there are ethnic differences in the history and current use of exercise as therapy for patients with knee or hip OA. The secondary objective was to compare Hispanic and NH patients with lower extremity OA with respect to their familiarity and perceptions of the efficacy and risk of exercise as treatment for OA. <h3>Methods</h3> Research participants≥50 years of age with chronic and frequent pain due to knee or hip OA were recruited from a university medical centre. Structured interviews were conducted to determine patient sociodemographic characteristics, clinical information, self-reported actual use/prescription receipt of exercise for OA treatment (currently, last 5 years), and familiarity with exercise (3 items, yes/no response). Perceptions of the benefits (4 items) and risks (3 items) of exercise, and willingness to exercise to treat OA were also evaluated; each question in these measures has a five-category ordinal response scale. Fisher's exact or Wilcoxon-Mann-Whitney tests were conducted to determine if knowledge and perceptions about exercise were associated with ethnicity (Hispanic vs NH). <h3>Results</h3> In our cohort of patients with knee or hip OA, Hispanics (n=119), in comparison to NHs (n=201), were younger (mean age 61.5 vs. 65.3) and less likely to have an annual income of ≥$50,000 (13.5% vs. 39.1%). A lower proportion of Hispanics than NHs reported using exercise to treat OA at present (51% vs. 66%, p=0.0165) and in the last five years (68% vs. 84%, p=0.0010) or receiving a prescription for exercise in the last five years (45% vs. 67%, p&lt;0.0001) (figure 1). Hispanics, compared to NHs, were also less likely to report ever hearing about exercise to treat OA (71.43% vs. 91.83%, p&lt;0.0001), having family/friends that received it for treatment (33.33% vs. 51.20%, p=0.0023), or having a good understanding of it as a treatment for OA (66.96% vs. 79.33%, p=0.0161). A lower proportion of Hispanics than NHs believe that exercise is beneficial (or very beneficial) for arthritis (49.12% vs. 69.09%, p&lt;0.0001) and that exercise is helpful (or very helpful) for them (60.52% vs. 75.61%, p=0.0056). No ethnic differences in the perceptions of risk of exercise were observed. Hispanics were also less willing to exercise to treat OA than NHs (67.83% vs. 82.61%, p=0.0018). <h3>Conclusions</h3> Among patients with knee or hip OA, Hispanics were less likely than NHs to utilise exercise as treatment for arthritis. They were also less familiar with its use for OA treatment, less likely to believe in its efficacy, and less willing to use it as treatment for OA. Improving patient knowledge and attitudes about exercise may increase utilisation of this OA treatment and help reduce ethnic differences in OA outcomes. <h3>Disclosure of Interest</h3> E. Vina: None declared, D. Ran: None declared, M. Hannon: None declared, C. Kwoh Grant/research support from: Abbvie, EMD Serono, Consultant for: Astellas, EMD Serono, Thusane, Express Scripts, Novartis