Variation in perceptions of treatment and self-care practices in elderly with osteoarthritis: A comparison between African American and White patients.

Ibrahim, S. A., Siminoff, L. A., Burant, C. J., & Kwoh, C. K. (2001). Arthritis Care & Research, 45(4), 340-345.

Arthritis is a leading cause of disability in the elderly, and it is estimated that by 2050 it will affect 60 million Americans and cost $65 billion in medical care and lost productivity. In the older population, osteoarthritis of the knee or hip is the most common type of arthritis and is equally prevalent in all ethnic groups. However, there is ethnic disparity in the use of total joint replacements as an end-stage treatment of osteoarthritis. White men are 3 to 5 times more likely than African American men to have a total knee replacement and are more likely to have a total hip replacement as well. The object of the study was to compare elderly male patients (593 patients-44% African American and 56% white) with osteoarthritis of the knee or hip with respect to their perceptions of the efficacy of medical treatments and self-care practices. The two groups were comparable with respect to age, disease severity or functional status, and comorbidities. All were patients in a Veterans Administration hospital.

The two races differ in their perceptions of the efficacy of standard medical treatments for arthritis, as well as in their reliance on self-care measures. African Americans are more likely to believe in the value of prayer and other forms of "complementary care," make greater use of over-the-counter medications such as Tylenol, consult chiropractors, and have less faith in the results of a total joint replacement. Cultural and social factors thus affect how different groups of patients perceive and deal with this chronic disease.