Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
OtherPractice

PEER simplified decision aid: osteoarthritis treatment options in primary care

Adrienne J. Lindblad, James McCormack, Christina S. Korownyk, Michael R. Kolber, Joey Ton, Danielle Perry, Betsy Thomas, Samantha Moe, Scott Garrison, Nicholas Dugré, Karenn Chan and G. Michael Allan
Canadian Family Physician March 2020, 66 (3) 191-193;
Adrienne J. Lindblad
Pharmacist and Knowledge Translation and Evidence Coordinator at the Alberta College of Family Physicians and Associate Clinical Professor in the Department of Family Medicine at the University of Alberta in Edmonton.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
James McCormack
Professor in the Faculty of Pharmaceutical Sciences at the University of British Columbia in Vancouver.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christina S. Korownyk
Family physician and Associate Professor in the Department of Family Medicine at the University of Alberta.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael R. Kolber
Family physician and Professor in the Department of Family Medicine at the University of Alberta.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joey Ton
Pharmacist and Clinical Evidence Expert for the College of Family Physicians of Canada in Edmonton.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Danielle Perry
Nurse and Clinical Evidence Expert at the Alberta College of Family Physicians.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Betsy Thomas
Pharmacist and Project Manager, Education and Knowledge Translation at the Alberta College of Family Physicians.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Samantha Moe
Pharmacist and Clinical Evidence Expert at the College of Family Physicians of Canada in Mississauga, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Scott Garrison
Family physician and Associate Professor in the Department of Family Medicine at the University of Alberta.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nicholas Dugré
Pharmacist at the CIUSSS du Nordde-l’Ile-de-Montréal and Clinical Associate Professor in the Faculty of Pharmacy at the University of Montreal in Quebec.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Karenn Chan
Care of the elderly physician and Assistant Professor in the Department of Family Medicine at the University of Alberta.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
G. Michael Allan
Family physician, Director of Programs and Practice Support at the College of Family Physicians of Canada, and Professor in the Department of Family Medicine at the University of Alberta.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • CFPlus
  • eLetters
  • Info & Metrics
  • PDF
Loading

This decision aid was developed for clinicians to help them discuss non-operative treatment options with patients living with osteoarthritis-related pain. It is derived from a systematic review of systematic reviews.1 Effectiveness data are generated from randomized controlled trials comparing active treatment with inert control, often placebo.1 The evidence focuses on the proportion of patients attaining meaningful reductions in pain, generally defined as a 30% or more reduction in pain, but specific definitions of clinically meaningful vary widely across studies.

How was this tool developed?

Icon arrays were developed using risk ratio estimates from meta-analyses for patients attaining clinically meaningful improvement in pain (page e89).1 The control response rate was standardized to 40%, the approximate control response rate averaged for all included studies. The rate ratio for each intervention was applied to the average 40% control rate to attain the estimated benefit for that intervention. Standardized control rates allow easier comparison of estimated benefits from differing interventions. However, it should be noted that the estimates are from inert-controlled trials and not direct comparisons, so differences between products are approximations with some uncertainty.

Publicly (not-for-profit) sponsored studies can find lower effectiveness of interventions than for-profit or industry-sponsored studies do.2 We indicated when pooled publicly sponsored studies did not find statistically significant benefit over placebo (glucosamine, chondroitin, and viscosupplementation). Adverse events were poorly reported in the systematic reviews included in our systematic review1 and so are inadequately reported here. Common prescribing resources or other studies should be consulted for further details on potential adverse events.

The decision aid

The decision aid (Figure 1)1,3–6 provides a 1-page summary (2-sided) of estimated effectiveness of treatment options for osteoarthritis pain. The back side of the page includes classification of therapies (by benefits and harms), withdrawals owing to adverse events, typical adverse events, basic prescribing tips, and estimated costs. An interactive version of treatment options can be found at www.pain-calculator.com. An easy-to-print version of the tool is also available from CFPlus.*

Figure
  • Download figure
  • Open in new tab
Figure
  • Download figure
  • Open in new tab

This decision aid is not a guideline, and the evidence was not assessed by an independent guideline committee for clinical application. Information presented here will be combined with similar systematic reviews and tools on other types of pain to inform future guideline development.

Acknowledgments

The tool was reviewed by patients and the Patient Education Committee of the College of Family Physicians of Canada. This tool was funded by Alberta Health through the Primary Health Care Opioid Response Initiative, as well as by the College of Family Physicians of Canada and the Alberta College of Family Physicians.

Notes

We encourage readers to share some of their practice experience: the neat little tricks that solve difficult clinical situations. Praxis articles can be submitted online at http://mc.manuscriptcentral.com/cfp or through the CFP website (www.cfp.ca) under “Authors and Reviewers.”

Footnotes

  • Competing interests

    None declared

  • This article is eligible for Mainpro+ certified Self-Learning credits. To earn credits, go to www.cfp.ca and click on the Mainpro+ link.

  • This article has been peer reviewed.

  • La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du numéro de mars 2020 à la page e86.

  • ↵* An easy-to-print version of the decision aid is available at www.cfp.ca. Go to the full text of the article online and click on the CFPlus tab.

  • Copyright© the College of Family Physicians of Canada

References

  1. 1.↵
    1. Ton J,
    2. Perry D,
    3. Thomas B,
    4. Allan GM,
    5. Lindblad AJ,
    6. McCormack J,
    7. et al
    . PEER umbrella systematic review of systematic reviews. Management of osteoarthritis in primary care. Can Fam Physician 2020;66:e89-98.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Lundh A,
    2. Lexchin J,
    3. Mintzes B,
    4. Schroll JB,
    5. Bero L
    . Industry sponsorship and research outcome: systematic review with meta-analysis. Intensive Care Med 2018;44(10):1603-12. Epub 2018 Aug 21.
    OpenUrl
  3. 3.↵
    1. Korownyk C,
    2. Allan GM
    . Motivating patients to activity. A light at the end of the couch? Can Fam Physician 2010;56:887.
    OpenUrlFREE Full Text
  4. 4.
    1. Jamieson J,
    2. Allan GM
    . Corticosteroid shots and knees: a match made in osteoarthritis heaven? Edmonton, AB: Alberta College of Family Physicians; 2015. Tools for Practice #135. Available from: https://gomainpro.ca/wp-content/uploads/tools-for-practice/1427727062_tfp135steroidsforkneeoa.pdf. Accessed 2020 Jan 2.
  5. 5.
    1. Allan GM,
    2. Turner R
    . Topical NSAIDs: do they top placebo or oral NSAIDs? Edmonton, AB: Alberta College of Family Physicians; 2015. Tools for Practice #40. Available from: https://gomainpro.ca/wp-content/uploads/tools-for-practice/1427230512_40updated-topicalnsaids.pdf. Accessed 2020 Jan 15.
  6. 6.↵
    1. Turgeon R,
    2. Allan GM,
    3. Harbin M,
    4. Kolber MR
    . NSAIDs and cardiovascular safety: the truth makes my heart hurt. Edmonton, AB: Alberta College of Family Physicians; 2018. Tools for Practice #101. Available from: https://gomainpro.ca/wp-content/uploads/tools-for-practice/1530897150_updatedtfp101nsaidscvrisk.pdf. Accessed 2020 Jan 2.
PreviousNext
Back to top

In this issue

Canadian Family Physician: 66 (3)
Canadian Family Physician
Vol. 66, Issue 3
1 Mar 2020
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
PEER simplified decision aid: osteoarthritis treatment options in primary care
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
PEER simplified decision aid: osteoarthritis treatment options in primary care
Adrienne J. Lindblad, James McCormack, Christina S. Korownyk, Michael R. Kolber, Joey Ton, Danielle Perry, Betsy Thomas, Samantha Moe, Scott Garrison, Nicholas Dugré, Karenn Chan, G. Michael Allan
Canadian Family Physician Mar 2020, 66 (3) 191-193;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
PEER simplified decision aid: osteoarthritis treatment options in primary care
Adrienne J. Lindblad, James McCormack, Christina S. Korownyk, Michael R. Kolber, Joey Ton, Danielle Perry, Betsy Thomas, Samantha Moe, Scott Garrison, Nicholas Dugré, Karenn Chan, G. Michael Allan
Canadian Family Physician Mar 2020, 66 (3) 191-193;
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • How was this tool developed?
    • The decision aid
    • Acknowledgments
    • Notes
    • Footnotes
    • References
  • Figures & Data
  • CFPlus
  • Info & Metrics
  • eLetters
  • PDF

Related Articles

  • Aide décisionnelle simplifiée de PEER : options pour le traitement de l’arthrose en première ligne
  • PEER umbrella systematic review of systematic reviews
  • Improving osteoarthritis care in family practice
  • PubMed
  • Google Scholar

Cited By...

  • La glucosamine et la chondroïtine sont-elles des remedes naturels pour larthrose?
  • Are glucosamine and chondroitin natural remedies for osteoarthritis?
  • La hausse du facteur dimpact du MFC
  • The rise of CFPs impact factor
  • Response
  • Misleading communication aid
  • Improving osteoarthritis care in family practice
  • PEER umbrella systematic review of systematic reviews: Management of osteoarthritis in primary care
  • Google Scholar

More in this TOC Section

Practice

  • Is 45 the new 50 in colorectal cancer screening?
  • Approach to diagnosis and management of childhood attention deficit hyperactivity disorder
  • Determining if and how older patients can safely stay at home with additional services
Show more Practice

Praxis

  • Examens et traitements à reconsidérer en médecine du sport et de l’exercice pédiatrique
  • Tests and treatments to question in pediatric sport and exercise medicine
  • Optimizing delirium assessment, management, and prevention
Show more Praxis

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • RSS Feeds

Copyright © 2023 by The College of Family Physicians of Canada

Powered by HighWire