Impact of Polypharmacy on Functional State in Patients with Symptomatic Knee Osteoarthritis

Abstract

Background: Osteoarthritis (OA) is a degenerative, common and progressive inflammatory joint disease starting with disruption and corrosion of articular cartilage. Polypharmacy can be considered as use of multiple drugs. Objective: To investigate the correlation between polypharmacy for patients with symptomatic knee osteoarthritis and their function, pain, daily life activities and quality of life. Method: Fifty patients, diagnosed with knee osteoarthritis according to the American College of Rheumatology (ACR) classification criteria, were included in this study. Patient’s demographic data, height, weight, body mass index, knee pain duration, number of painful knees, drugs used for treatment of comorbid diseases and knee osteoarthritis as well as drugs used for other diseases were recorded. Using 5 or more drugs were regarded as polypharmacy in this study. Characteristics of patients with polypharmacy were compared to those without polypharmacy. Kellgren-Lawrence Classification was used for radiological grading of knee osteoarthritis of the patients. Knee osteoarthritis related symptoms and functional state were evaluated by Knee Injury and Osteoarthritis Outcome Score (KOOS). Mini Mental State Examination (MMSE) was used for identifying the cognitive level. Result: Mean age of the patients included in the study was 64±13.7 years. 35 patients (70%) were female. Mean body mass index was 30.6±4.2 kg/m2. Mean knee pain duration was 4.9±3.8 years. 30 patients (60%) had bilateral knee involvement. Twenty-one patient (42%) had polypharmacy. While NSAIDs is the most frequently used drug, the most frequently observed comorbidity was hypertension. Kellgren Lawrence grade was significantly (p ˂ 0.05) higher in the group with polypharmacy than the group without polypharmacy. KOOS symptoms, pain, function-daily life, sport recreational acts, quality of life and total score and MMS total score were significantly (p ˂ 0.05) lower in the group with polypharmacy than the group without polypharmacy. Discussion: It has been observed that polypharmacy affects the functional state and quality of life negatively in patients with knee osteoarthritis. Conclusion: Attention must be paid to the training activities raising awareness for appropriate drug use, and awareness of the physicians as well as elderly people regarding the polypharmacy must be expanded.