Patient and Physician Preferences for Pain Relief Treatment for Knee Osteoarthritis: Formative Qualitative Research for a Discrete Choice Experiment

OBJECTIVES: Obtaining a better understanding of patient and physician preferences for pharmacological pain relief treatment for knee osteoarthritis (KOA) may be useful for guiding the appraisal of new treatments. This study sought to understand these preferences qualitatively to inform attribute selection for a discrete choice experiment (DCE).

METHODS: Semi-structured telephone interviews were conducted with patients and physicians in six countries (France, Germany, Italy, Spain, UK, USA). Patients were eligible if they regularly experienced moderate-to-severe pain associated with KOA and had been prescribed pain relief treatment. The physicians interviewed were primarily orthopedists and rheumatologists with experience treating KOA. The overall approach and interview guide was informed by a Patient Advisory Group and an Academic Steering Group. Thematic analysis was conducted.

RESULTS: We conducted 72 interviews (48 patients and 24 physicians). Among patients, the most important benefits were pain relief itself, improvement in function, and ability to conduct usual activities. Patients were comfortable describing their pain using a numerical scale. Delaying the need for knee replacement surgery was considered a benefit of pain relief treatment by patients and physicians. However, physicians noted that this depends on the patients’ health state and current levels of pain management. Physicians were more aware of potential side effects than patients. Views on the preferred mode of administration for pain relief were mixed. However, patients were generally open to trying intra-articular injections if their pain was not managed sufficiently. Those with experience of intra-articular injections typically reported having a positive experience.

CONCLUSIONS: Patient and physician preferences are broadly aligned regarding pain relief treatment benefits. The qualitative interview findings alongside input from advisory groups will inform attribute selection for a DCE, to examine the relative importance of attributes and the trade-offs they are willing to make.