Patient and Healthcare Professional Perspectives on Knee Osteoarthritis Management in Saudi Arabia: A Qualitative...

Knee osteoarthritis (OA) is a leading cause of pain and disability worldwide, with cultural and lifestyle factors shaping its burden in different populations. In Saudi Arabia, the perspectives of both patients and healthcare professionals (HCPs) remain underexplored in understanding management approaches. This study aimed to explore patients' and HCPs' perspectives on management strategies for knee osteoarthritis in Saudi Arabia.

A qualitative exploratory study was conducted using focus group discussions (FGDs). Participants included patients with knee OA and HCPs involved in knee OA management recruited from three hospitals within Riyadh's First Health Cluster. FGDs were conducted separately for patients and HCPs using a semi-structured interview guide. Discussions were audio-recorded, transcribed verbatim in Arabic, and translated into English using forward-backward translation. Data were analysed inductively using reflexive thematic analysis.

A total of 58 participants (30 patients and 28 HCPs) were included. Five overarching themes were identified: (i) understanding and risk factors of knee OA, (ii) clinical versus lived experience, (iii) treatment and management priorities, (iv) education and self-management, and (v) barriers and facilitators to adherence. Healthcare professionals demonstrated a biomedical understanding of knee OA, whereas patients showed variable knowledge and uncertainty. Although both groups recognised obesity and physical inactivity as key risk factors, a gap existed between knowledge and behaviour. Patients reported broader impacts on daily life and psychological well-being, which HCPs emphasised less. Divergence in treatment priorities was observed, with HCPs emphasising exercise while patients relied more on pharmacological management. Barriers to adherence included limited understanding, low motivation, and constraints in the healthcare system, while facilitators included social support and perceived improvement.

Knee OA management in Saudi Arabia is influenced by misalignment between clinical approaches and patient experiences, as well as cultural and system-level factors. Addressing these gaps through patient-centred, culturally tailored interventions and improved support for self-management may enhance adherence and outcomes.