POS1166 UNDERSTANDING PRESCRIPTION BEHAVIOR ACROSS HEALTHCARE PROFESSIONALS IN TREATING KNEE OSTEOARTHRITIS BEFORE AND DURING THE 2020 COVID-19 PANDEMIC
Authors: D. Baldock, E. Baynton, H. Hamdan
Journal: Annals of the Rheumatic Diseases (2021)

Background: Knee Osteoarthritis (OA) treatment aims to provide symptom relief, easing joint pain and enabling mobility. The COVID-19 pandemic affected healthcare systems globally, including ways OA patients were treated. Objectives: This study is to understand how treatment management of knee OA patients and prescribing behavior across US healthcare professionals (HCPs) was affected when COVID-19 impacted healthcare systems and regimes globally Methods: A multi-center online medical chart review study of patients with OA was conducted between May – July 2019 &amp; 2020 among US rheumatologists (rheums), orthopedic surgeons (orthos), primary care physicians with a focus in sports medicine (SM PCPs), and pain specialists, practicing across hospital and private practices. Recruited from a large access panel, physicians were screened for duration of practice in their specialty (3-50 years) and caseload (35 or more knee OA patients personally managed, at least 10 of which must be classified as moderate-severe). Patient charts were recorded for the next 5 eligible patients seen during the screening period. Respondents abstracted patient demographics and treatment regimes used. Descriptive statistics were used to analyse the data Results: 275 physicians were recruited and collectively reported 1375 patients between May-Jul 2019; 260 physicians were recruited and collectively reported 1300 patients between May-Jul 2020. Looking at treatments patients were receiving at time of reporting, oral medications, particularly NSAIDs, were widely used, regardless of the physician specialty. A directional increase of 6% in the proportion of reported patients deriving from sampled primary care SM PCPs from pre-COVID (Q219) to during COVID (Q220), whilst the same is not true for rheums, orthos, and pain specialists. Figure 1. Medication usage in reported knee OA patients across all sampled specialties - Q2 2019 vs Q2 2020 With regards to the usage of injectable therapy, the opposite pattern is seen - higher proportions of reported patients deriving from sampled rheums, orthos &amp; pain specialists receiving injectables vs those deriving from sampled SM PCPs. While focusing on orthos, the proportion of reported patients deriving from them who receive injectables grew by 5% in Q220 (during COVID) vs Q219 (pre-COVID) – directionally more so than other specialties. This is possibly due to limited elective surgeries during the pandemic. Looking deeper into injectable usage amongst reported patients deriving from sampled rheums and orthos, the proportion of the total reported patient set receiving this treatment type is relatively similar across both specialties, prior to, and during the COVID-19 pandemic. However, among reported patients who received surgery, a directionally higher proportion of this reported patient cohort deriving from orthos are noted to receive injectables vs those from rheums – this is true both pre- and during the pandemic. Conclusion: From the sample surveyed, it appears that primary care SM PCPs adopted their treatment adjustment during COVID-19 pandemic differently, by prescribing more orals, while other secondary care physicians (rheums, orthos, pain specialists) focused on injection treatment for longer pain relief. Considering movement restrictions and limited elective surgeries during the pandemic, the lack of targeted treatment options for knee OA has been made more apparent. With a burgeoning pipeline, many of which are targeted therapies, it is hopeful that knee OA treaters will be less reliant on symptom remedies and can readily offer patients’ longer-acting pain relief or disease modifying options to combat joint deterioration References: [1]Ipsos Osteoarthritis Therapy Monitor (May – July 2019, 275 specialists reporting on 1375 OA patients seen in consultation; May – July 2020, 260 specialists reporting on 1300 OA patients seen in consultation, data collected online. Participating physicians were primary treaters and saw a minimum number of 35 knee OA patients). Data © Ipsos 2021, all rights reserved. Disclosure of Interests: None declared.