OBJECTIVES:To deprescribe inappropriate utilization of analgesics and replacement with physiotherapy(PT).Long term analgesics utilization may cause adverse effects like gastrointestinal bleeding, hepatotoxicity, renal toxicity, and cardiovascular abnormalities.

METHODS: A prospective interventional study was conducted for 8 months from September 2018 to April 2019 in the Department of Orthopedics, Ramaiah hospital, Bangalore, Karnataka, India.Knee Osteoarthritis (OA) patients of either gender >18 years having mild to moderate pain were included. Patients experiencing severe pain were excluded.The patient history was obtained through case sheets and interview. Patients were explained administration of analgesics may subside OA pain but cessation of disease progression may not be possible. Patients willing to accept deprescribing were taught suitable PT exercises by experienced physiotherapist. Pain was assessed by pain assessment tool at baseline and 4^th week.

RESULTS:Among 230(100%) patients enrolled,31(13.4%) patients didn’t agree for deprescribing and inclusion of PT as part of treatment. Remaining 199(100%)patients accepted for deprescribing after counseling about pain and disease nature. Out of 199 patients,for 162(81%) patients absolute cessation of analgesics and inclusion of physiotherapy was done. Other 37(19%) patients consumed analgesics and also performed PT.Paired t-test was used to evaluate QoL using WOMAC and found to be significant (p<.000). Patients underwent PT showed pain relief without consuming analgesics, which indicated that analgesics can be deprescribed in case of knee OA patients with mild and moderate pain.

CONCLUSIONS: Patients consuming analgesics and performed PT had better pain relief but experienced pain if medicines are missed. But, patients with complete cessation of analgesics and regular physiotherapy had gradual pain reduction but had consistent improvement in disease. PT decreased the pain intensity and improved the range of motion of knees, enhancing isometric quadriceps strength, and level of functional performance in patients.

Key words: Deprescribing, Analgesics, Physiotherapy, Pain reduction.