In a session at the 2025 EULAR congress in Barcelona, important findings were presented from the BLOAR registry, taking in data from 1,716 people with osteoarthritis treated in everyday clinical practice in Austria. This registry collects comprehensive clinical and demographic information from physicians and therapists, as well as patient-reported outcomes such as information on pain, quality of life, physical activity, and disease severity.
The findings show that most people are being treated for osteoarthritis in the knee (52.2%), followed by hand (23.5%), hip (17.7%), and other joints (6.7%). Over 80% were moderately or severely affected by their disease, and 16% reported having reduced their workhours or lost their job. On a scale of 1–100, pain was on average 24.7 at rest, and 42.8 during activity.
Overall, 67.0% reported consultations and visits to doctors; 61.4% had received physiotherapy (active, functional therapy with a licensed physiotherapist) and 60.4% had physical therapy (medically prescribed passive modalities such as electrotherapy, heat, cold, ultrasound, or hydrotherapy). However, surprisingly, only 11.8% reported having received dietary interventions and weight management programs. Only 37.5% were using medications, including pain-relief, but many people were taking vitamins (40.3%) and plant-based products (12.6%).
The results show a significant gap between real-world practice and the existing EULAR recommendations. Interventions around weight management are strongly emphasised in the guidelines, which state that "people with hip or knee osteoarthritis should be offered education on the importance of maintaining a healthy weight; those overweight or obese should be offered support to achieve and maintain weight loss",1 but in real-world settings these approaches are not being used, with only about 10% of patients receiving such support.
Valentina Schmolik said "while close to 70% of patients receive consultations and physiotherapy or physical therapy, there is a high prevalence of non-evidence-based treatments, such as taking vitamins and plant-based products – neither of which are recommended by EULAR – and this is surprising."
The authors say these findings from BLOAR underscore the need to raise awareness of evidence-based interventions in clinical practice, and to implement them more effectively.
Healthcare providers should prioritise aligning treatment approaches with established guidelines to optimise outcomes for people with osteoarthritis. Furthermore, the popularity of non-standardised treatments suggests the importance of understanding patient preferences and addressing misconceptions through targeted education and communication strategies.
Source
Schmolik V, et al. Health services usage in the Austrian osteoarthritis registry show a high level of non-evidence-based therapies. Presented at EULAR 2025; OP0236-HPR.
Ann Rheum Dis 2025; DOI: 10.1136/annrheumdis-2025-eular.C381.
References
1. Moseng T, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update. Ann Rheum Dis 2024;83:730–40. DOI: 10.1136/ard-2023-225041.
2. Kloppenburg M, et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis 2019;78:16–24. DOI: 10.1136/annrheumdis-2018-213826.
About EULAR
EULAR is the European umbrella organisation representing scientific societies, health professional associations and organisations for people with rheumatic and musculoskeletal diseases (RMDs). EULAR aims to reduce the impact of RMDs on individuals and society, as well as improve RMD treatments, prevention, and rehabilitation. To this end, EULAR fosters excellence in rheumatology education and research, promotes the translation of research advances into daily care, and advocates for the recognition of the needs of those living with RMDs by EU institutions.
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