Analysis of management tactics in the treatment of patients with osteoarthritis in the population of the Republic of Tajikistan

Objective: to assess the real practice of prescribing drugs for osteoarthritis (OA) by physicians in the Republic of Tajikistan. Subjects and methods. The paper presents the results of a questionnaire survey of 274 physicians of different specialties (therapists, rheumatologists, traumatologists, surgeons, neurologists, and family medicine specialists) in order to identify common prescribing practice in the treatment of patients with OA in the Republic of Tajikistan. It shows changes in the doctors' therapeutic tactics (in 2013 and 2015) in terms of the introduction of the national management protocol for patients with OA. The results were compared with the data of evidence-based medicine; ways for the optimal introduction of efficient techniques into the practical activity of doctors were sought for. Results and discussion. The analysis of the survey showed that in clinical practice the majority (97.8%) of physicians considered it necessary to use nonsteroidal anti-inflammatory drugs (NSAIDs) in OA. It was ascertained that the physicians commonly prescribed diclofenac (64% in 2013 and 48.6% in 2015), ibuprofen (38.2 and 37.3%), nimesulide (33.7 and 36.2%), and indomethacin (14.6 and 18.9%). They more rarely used lornoxicam or meloxicam (15.7% in 2013 and 18.4% in 2015) and coxibs (14.6 and 8.6%). In 2013, structure-modifying drugs were prescribed only in 7.8% of cases; this figure was 50.3% in 2015. The analysis of local (intra-articular) therapy indicated that glucocorticoids (hydrocortisone (6%), triamcinolone (11%), and betamethasone (14%)) were used in 31% of cases. In their practice, only 7% of the respondents prescribed intra-articular hyaluronic acid injections. NSAIDs were established to be the drugs of choice by physicians in treating patients with OA; in this case, non-selective NSAIDs were more commonly prescribed due to their availability, whereas chondroprotectors were administered less frequently, although there was an increase in the frequency of their use after introducing the national protocols for treating rheumatic diseases.