| アブストラクト | OBJECTIVE: Osteoarthritis (OA) affects 10% of adults in the UK. Despite over one-third of people with OA experiencing chronic pain, few studies have examined the population-level impact of chronic pain associated with OA. We compared resource-use and epidemiological outcomes in patients with mild, moderate and severe chronic OA-associated pain and matched controls without known OA. DESIGN: Retrospective, longitudinal, observational cohort study (July 2008 to June 2019). SETTING: Electronic records extracted from Clinical Practice Research Datalink GOLD primary care linked to Hospital Episode Statistics (HES). PARTICIPANTS: Patients (cases; n=23 016) aged >/=18 years with chronic OA-associated pain. Controls (n=23 016) without OA or chronic pain matched on age, sex, comorbidity burden, general practitioner practice and available HES data. INTERVENTIONS: None. PRIMARY AND SECONDARY OUTCOME MEASURES: Total healthcare resource use (HCRU), direct healthcare costs in 0-12, 12-24 and 24-36 months postindex. Secondary outcomes included incidence and prevalence of chronic OA-associated pain and pharmacological management. RESULTS: HCRU was consistently greater in cases versus controls for all resource categories during preindex and postindex periods. Across follow-up periods, resource use was greatest in patients with severe pain. In the first 12 months postindexing, mean total costs incurred by cases were four times higher versus matched controls ( pound256 vs pound62); costs were approximately twice as high in cases vs controls for months 12-24 ( pound166 vs pound86) and 24-36 ( pound150 vs pound81; all p<0.0001). The incidence of new cases of chronic pain associated with OA was 2.64 per 1000 person-years; the prevalence was 1.4%. CONCLUSIONS: This study highlights the real-world cost of chronic pain associated with OA in cases versus matched controls. We included patients with mild, moderate and severe pain associated with OA, and showed HCRU in discrete 1-year time frames. The true economic burden of pain associated with OA is likely to be considerably higher when indirect costs are considered. |
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| ジャーナル名 | BMJ open |
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| 投稿日 | 2023/11/30 |
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| 投稿者 | Lohan, Christoph; Coates, Greg; Clewes, Peter; Stevenson, Hannah; Wood, Robert; Tritton, Theo; Massey, Lucy; Knaggs, Roger; Dickson, Alastair J; Walsh, David |
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| 組織名 | Pfizer Australia Pty Ltd, Sydney, New South Wales, Australia.;Pfizer Ltd, Tadworth, UK.;Adelphi Real World, Bollington, UK robert.wood@adelphigroup.com.;Adelphi Real World, Bollington, UK.;Pain Centre Versus Arthritis and NIHR Nottingham Biomedical Research Centre,;School of Pharmacy, University of Nottingham, Nottingham, UK.;Primary Care Rheumatology & Musculoskeletal Medicine Society, York, UK.;The North of England Low Back Pain Pathway, NIHR Applied Research Collaboration;(ARC) North East and North Cumbria, Saint Nicholas Hospital, Newcastle upon Tyne,;UK.;School of Medicine, University of Nottingham, Nottingham, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38030255/ |
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