The Patient Experience of Living With Knee Osteoarthritis Pain: Development of a Conceptual Model

Knee osteoarthritis (KOA) is a chronic degenerative condition. Pain is the most prominent symptom of KOA, which can be exacerbated by obesity. The US Food and Drug Administration recommends using patient-reported outcome (PRO) measures to assess KOA pain and function in clinical trials, but none have been validated for patients with KOA and obesity/overweight. The objective of this study was to explore and document the patient experience of signs, symptoms, and health-related quality of life (HRQoL) impacts of KOA pain, including the impact of obesity/overweight, to facilitate future validation studies.

A targeted literature review and interviews with US participants with KOA pain (including some with comorbid obesity) were conducted. Publications and interview transcripts were analysed using content analysis methods to develop a conceptual model of KOA pain experience.

Eighteen publications were reviewed and 25 participants were interviewed. All participants in the interviews reported knee pain and described that their physical functioning had been negatively affected. Many experienced a negative emotional/psychological impact. Many participants believed that there was a relationship between their weight and experience of KOA pain, reporting a 'vicious cycle' of pain and weight gain due to KOA.

This study highlights the burden of living with KOA pain and the negative impact of obesity/overweight on patients' HRQoL. A conceptual model was developed, which may be used to explore the content validity of PRO measures and promote a robust understanding of the patient experience of living with KOA pain during the development of new therapies.