Greg Coates
Health economic impact of moderate-to-severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data
Coates, Greg; Clewes, Peter; Lohan, Christoph; Stevenson, Hannah; Wood, Robert; Tritton, Theo; Knaggs, Roger; Dickson, Alastair J.; Walsh, David
Authors
Peter Clewes
Christoph Lohan
Hannah Stevenson
Robert Wood
Theo Tritton
ROGER KNAGGS Roger.Knaggs@nottingham.ac.uk
Associate Professor
Alastair J. Dickson
DAVID WALSH david.walsh@nottingham.ac.uk
Professor of Rheumatology
Abstract
Objective: Despite the prevalence of osteoarthritis (OA) in England, few studies have examined the health economic impact of chronic pain associated with OA. The aim of this study was to compare outcomes in patients with moderate-to-severe chronic pain associated with OA and matched controls without known OA. Design: Retrospective, longitudinal, observational cohort study. Setting: Electronic records extracted from the Clinical Practice Research Datalink GOLD primary care database linked to Hospital Episode Statistics (HES) data set. Participants: Patients (cases; n=5931) ≥18 years and with existing diagnosis of OA and moderate-to-severe pain associated with their OA, and controls matched on age, sex, comorbidity burden, general practitioner (GP) practice and availability of HES data. Interventions: None. Primary and secondary outcome measures: Total healthcare resource use (HCRU) and direct healthcare costs during 0–6, 0–12, 0–24 and 0–36 months of follow-up. Secondary outcomes measures included pharmacological management and time to total joint replacement. Results: Patients with moderate-to-severe chronic pain associated with OA used significantly more healthcare services versus matched controls, reflected by higher HCRU and significantly higher direct costs. During the first 12 months’ follow-up, cases had significantly more GP consultations, outpatient attendances, emergency department visits and inpatient stays than matched controls (all p<0.0001). Total mean costs incurred by cases during 0–12 months’ follow-up were five times higher in cases versus controls (mean (SD): £4199 (£3966) vs £781 (£2073), respectively). Extensive cycling through pharmacological therapies was observed; among cases, 2040 (34.4%), 1340 (22.6%), 841 (14.2%), 459 (7.7%) and 706 (11.9%) received 1–5, 6–10, 11–15, 16–20 and >20 lines of therapy, respectively. Conclusions: This wide-ranging, longitudinal, observational study of real-world primary and secondary care data demonstrates the impact of moderate-to-severe chronic pain associated with OA in patients compared with matched controls. Further studies are required to fully quantify the health economic burden of moderate-to-severe pain associated with OA.
Journal Article Type | Article |
---|---|
Acceptance Date | Jun 28, 2023 |
Online Publication Date | Jul 12, 2023 |
Publication Date | 2023-07 |
Deposit Date | Aug 22, 2023 |
Publicly Available Date | Aug 23, 2023 |
Journal | BMJ Open |
Electronic ISSN | 2044-6055 |
Publisher | BMJ |
Peer Reviewed | Peer Reviewed |
Volume | 13 |
Issue | 7 |
Article Number | e067545 |
DOI | https://doi.org/10.1136/bmjopen-2022-067545 |
Keywords | HEALTH ECONOMICS, PAIN MANAGEMENT, Musculoskeletal disorders |
Public URL | https://nottingham-repository.worktribe.com/output/23472432 |
Publisher URL | https://bmjopen.bmj.com/content/13/7/e067545 |
Files
e067545.full
(1.3 Mb)
PDF
Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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