Most patients with osteoarthritis (OA) do not seek care at community pharmacies for joint symptoms, although many support an expanded pharmacy role in medication management, exercise counseling, and referrals. This is according to study findings published in Arthritis Care & Research.
Researchers assessed how patients with OA use community pharmacies and their views on expanding pharmacy-based care beyond medication advice. The study also examined perceived barriers and facilitators to delivering additional OA management services.
The multimethod study included a cross-sectional survey and semistructured interviews conducted between August and December 2022. Eligible participants were adults aged 45 years and older who had consulted for joint pain likely attributable to OA within the preceding 2 years at 2 general practices in England.
The survey assessed previous pharmacy use, joint symptoms, preferences for pharmacy-based OA services, and perceived implementation barriers. Researchers analyzed survey responses using descriptive statistics and conducted a thematic analysis of interviews to further explore patient experiences and preferences.
Community pharmacy care for OA…would need to carefully address the identified barriers and facilitators to be successfully implemented in clinical practice.
Of 2000 individuals invited to participate, 450 returned surveys, with 448 providing responses eligible for analysis (response rate, 22.4%). Mean respondent age was 68.7±10.1 years; 58% were women, and 69% were retired. Most participants identified as White British, and 59% of respondents to the relevant question reported at least 1 additional long-term health condition.
Knees, hands, hips, and feet were the most frequently affected joints (74%, 65%, 65%, and 57%, respectively). Mean knee pain intensity during the preceding 3 months was 4.58±3.5 on a 10-point scale.
Most respondents (92%; n = 392) had not visited a community pharmacy for OA management during the previous 3 months. Reasons included not requiring pharmacy services (45.2%), preferring another health care professional (45.1%), and concerns about pharmacists’ inability to arrange diagnostic investigations (43.3%).
Among the 34 respondents who had visited a pharmacy for OA, 52.9% received medication advice; 17.6% received general guidance on managing their condition. Only 5.9% reported receiving exercise or physical activity counseling, while 2.9% received weight management advice. Additionally, 11.8% reported receiving an OA diagnosis from a pharmacist.
Despite limited utilization, respondents generally supported greater pharmacy involvement in OA care. Most agreed that pharmacists should ask about joint symptoms (73.9%), their effects on daily activities (75.0%), other health conditions (78.2%), and previous treatments (77.4%).
Regarding treatment, 72.1% supported pharmacists recommending simple analgesics, 69.8% favored guidance on strengthening exercises, and 63.8% supported advice on increasing physical activity. Most also agreed that pharmacists should provide weight management support when appropriate (71.8%) and written information about joint conditions (67.6%).
Support was particularly high for pharmacists referring patients to other health care professionals when necessary (82.1%) and communicating consultation findings to general practitioners (79.5%). However, fewer respondents (52.2%) agreed that pharmacists should perform joint examinations.
Researchers also interviewed 18 survey respondents to further assess preferences for expanded pharmacy services. The interview participants had a mean age of 71.6±8.8, half were women, and all identified as White British.
Interview findings indicated that participants generally considered pharmacists suitable providers of medication reviews, treatment education, and self-management guidance. Participants also supported pharmacy involvement in promoting exercise, weight management, and access to community resources.
However, views differed regarding pharmacists’ involvement in OA diagnosis and physical assessment. Some participants preferred evaluation by general practitioners or physiotherapists, citing concerns about pharmacists’ training and limited access to medical histories. Others considered diagnostic responsibilities acceptable with additional professional training.
Participants identified high workloads, staffing shortages, and restricted access to patient records as barriers to expanded pharmacy services. Potential facilitators included additional clinical training, private consultation areas, improved communication with general practitioners, and greater public awareness of available pharmacy services.
Study limitations included limited ethnic diversity, recruitment from only 2 general practices, and potential responder bias, as respondents may have been more engaged with health care services than nonrespondents. These factors may limit the generalizability of the findings.
“Potentially acceptable community pharmacy care for OA could consist of providing information and advice on best use of medicine, physical activity, and exercise, but it would need to carefully address the identified barriers and facilitators to be successfully implemented in clinical practice,” the study authors concluded.
