Evaluation of patients’ and physicians’ expectations and attributes of osteoarthritis treatment using Kano methodology

To evaluate expectations regarding osteoarthritis (OA) treatment of patients (PT) and physicians (PH) (Orthopedic Surgeons)
in Spain.

Multicenter, cross-sectional study in adult patients with OA with at least 1 year of disease progression and with at least
one prescription of anti-inflammatory drugs within the last year. Sociodemographic, clinical, and treatment characteristics
as well as patient-reported outcomes were obtained by phone interview. Using a treatment expectations questionnaire and applying
Kano methodology, treatment attributes were classified as: must-be; one-directional; attractive; indifferent; reverse or questionable.

A total of 965 adult patients with OA [mean age: 64 years (SD: 11); 75% women] and 383 PH [mean age: 47 years (SD: 10); 14%
women] were surveyed. None of the treatment attributes showed a dominant “must-be” characteristic. The attributes that led
to a greater dissatisfaction when absent were non-occurrence of long-term adverse effects, no discomfort upon administration,
and achievement of symptoms relief. The two attributes that were considered most important by PT were as follows: achievement
of both total disappearance of the symptoms and lasting symptom relief. Conversely, for PH, the two most important attributes
were related to short- and long-term safety.

A clear different perspective regarding treatment expectation was noted among PT (effectiveness) and PH (safety). Therefore,
when selecting the most appropriate treatment for OA, PH should invite PT to participate in the decision making.