Table 2.

Summary of results

Impact	Summary
Epidemiology	Psychological factors such as anxiety and depression are commonly prevalent in patients with OA.
OA symptoms	Anxiety and depression contribute to index joint pain and its intensity. This pain can predict future fatigue, disability, and depressed mood.
OA outcomes	Anxiety and depression increase GP visits, health care and drug utilization, post-surgical pain, and adverse outcomes.
Sex differences	Anxiety and depression differentially impact lives of male and female patients with OA, with females showing higher levels of depressed mood.
Management challenges	Summary	Suggestions
Challenges in diagnosis	Physicians found it difficult to diagnose anxiety and/or depression in patients with OA.	Adopt NICE guidelines toward holistic assessment of patients with OA.
Challenges in self-care, collaborative care, social/phone support	Anxiety and depression pose as a challenge to physicians in structuring a management plan. Studies have reported use of various management programs with variable success.	Use “à la carte” approach. Thorough timely patient assessment required following initiation of program to access for improvement.
Challenges in pharmacotherapy	Rofecoxib and tapentadol were reported to have favorable results.	Cocktail pharmacotherapy. Other drugs like duloxetine have been approved by FDA for use in this patient cohort.
New management approaches	Music, video, and yoga have been tried with favorable results.	Can be employed as adjuvants.

Abbreviations: FDA, US Food and Drug Administration; GP, general practitioner; NICE, National Institute for Health and Care Excellence; OA, osteoarthritis.