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

Qual Life Res. 2012 Oct;21(8):1391-404. doi: 10.1007/s11136-011-0058-6. Epub 2011 Dec 2.


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

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Caregivers / psychology*
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Status Indicators
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis / drug therapy
  • Osteoarthritis / pathology
  • Osteoarthritis / psychology*
  • Pain Measurement
  • Patient Care / psychology*
  • Patient Care / standards
  • Physicians / psychology*
  • Research Design*
  • Residence Characteristics*
  • Self Report
  • Spain
  • Surveys and Questionnaires


  • Anti-Inflammatory Agents, Non-Steroidal