Treatment Utilisation and Satisfaction With Management in Individuals With Osteoarthritis and Metabolic Multimorbidity: A Cross-Sectional Multi-Country Study

Purpose: To compare treatment utilisation for osteoarthritis (OA) and satisfaction with OA management between individuals with and without comorbid metabolic conditions (e.g., diabetes, obesity, dyslipidaemia, hypertension). Methods: Secondary analysis of a cross-sectional international survey study (Italy, Russia, Sweden) on people ≥ 40 years old with knee/hip OA. Metabolic comorbidity was self-reported. We used direct standardisation with prevalence ratios and mixed-effect models to estimate the associations between comorbidity with treatment utilisation and satisfaction (score 0–100). Results: We analysed 401 individuals (48% Sweden, 28% Italy, 24% Russia; 53% with ≥ 1 metabolic condition). Those with and without comorbid metabolic conditions showed similar prevalence for first-line interventions (exercise, education, and weight management). Metabolically unhealthy individuals showed higher use of opioids (prevalence ratio [95% CI] 1.9 [1.3–2.4]), antidepressants (1.8 [1.1–2.5]), corticosteroid injections (1.4 [1.0−1.8]), and homoeopathic products (2.1 [1.2–3.0]). Satisfaction with care (adjusted difference: −3.9 [95% CI: −8.5 to 2.4]) and information received about treatments (−4.0 [−9.7 to 1.7]) were similar. Conclusions: While first-line OA interventions were similarly used, those with metabolic conditions relied more on second-line and non-recommended treatments, showing comparable satisfaction. More effort is needed to increase the adoption of lifestyle-focused treatments in OA and to minimise the use of less recommended options among individuals with metabolic comorbidities.