Where Have All the Patients Gone?

Profile of US Adults who Report Doctor-diagnosed Arthritis But Are Not Being Treated

Kristina A. Theis, PhD; Teresa J. Brady, PhD; Jeffrey J. Sacks, MD, MPH


J Clin Rheumatol. 2019;25(8):341-347. 

In This Article

Abstract and Introduction


Background: Patients only benefit from clinical management of arthritis if they are under the care of a physician or other health professional.

Objectives: We profiled adults who reported doctor-diagnosed arthritis who are not currently being treated for it to understand better who they are.

Methods: Individuals with no current treatment (NCT) were identified by "no" to "Are you currently being treated by a doctor or other health professional for arthritis or joint symptoms?" Demographics, current symptoms, physical functioning, arthritis limitations and interference in life activities, and level of agreement with treatment and attitude statements were assessed in this cross-sectional, descriptive study of noninstitutionalized US adults aged 45 years or older with self-reported, doctor-diagnosed arthritis (n = 1793).

Results: More than half of the study population, 52%, reported NCT (n = 920). Of those with NCT, 27% reported fair/poor health, 40% reported being limited by their arthritis, 51% had daily arthritis pain, 59% reported 2 or more symptomatic joints, and 19% reported the lowest third of physical functioning. Despite NCT, 83% with NCT agreed or strongly agreed with the importance of seeing a doctor for diagnosis and treatment.

Conclusions: Greater than half of those aged 45 years or older with arthritis were not currently being treated for it, substantial proportions of whom experienced severe symptoms and poor physical function and may benefit from clinical management and guidance, complemented by community-delivered public health interventions (self-management education, physical activity). Further research to understand the reasons for NCT may identify promising intervention points to address missed treatment opportunities and improve quality of life and functioning.


Arthritis is treatable. For example, osteoarthritis,[1–7] rheumatoid arthritis,[8–10] gout,[11,12] ankylosing spondylitis,[13] and lupus[14,15] all have a strong evidence base for clinical, pharmacologic, nonpharmacologic, and/or surgical treatments to ameliorate pain and functional loss. Several organizations, including the American College of Rheumatology,[1,8,11,12,14,15] the European League Against Rheumatism,[3,9,13] and the Osteoarthritis Research Society International,[2,5,6] endorse treatment guidelines to aid clinicians in providing the best, most current, and most appropriate care for their patients with arthritis. Of course, patients only reap the benefits from advances in the clinical treatment and management of rheumatic conditions if they are under the care of a health professional. The objective of this study was to profile adults who report doctor-diagnosed arthritis who do not receive current treatment for their arthritis in an attempt to understand better who they are.