Clinical, humanistic, and economic burden of osteoarthritis among noninstitutionalized adults in the United States

Zhao, Xiaohui; Shah, Drishti; Gandhi, Kavita; Wei, Wenhui; Dwibedi, Nilanjana; Webster, Lynn R.; Sambamoorthi, Usha

doi:10.1016/j.joca.2019.07.002

Cited by 113 publications

(123 citation statements)

References 22 publications

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“…Consistent with other recent studies that have addressed the relationship of current OA severity and HCRU crosssectionally (in the months pre-severity assessment) [8] and longitudinally (in the months post-severity assessment) [12], both methods identified increased hospitalizations and OArelated HCP visits as positively associated with pain severity. Although hospitalizations for OA are infrequent, they represent a large proportion of the overall economic cost of OA management [18].…”

Section: Discussionsupporting

confidence: 87%

“…A potential consequence of a rise in OA rates is an increasing burden on healthcare resources [6]. Recent studies have shown that in the US, patients with OA utilized more healthcare resources compared to similar patients without OA in privately insured and a noninstitutionalized, nationally represented study sample [7,8]. This equated to increases in healthcare costs that were 4 times and 2.5 times higher in patients with OA versus without in the respective populations [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies have shown that in the US, patients with OA utilized more healthcare resources compared to similar patients without OA in privately insured and a noninstitutionalized, nationally represented study sample [7,8]. This equated to increases in healthcare costs that were 4 times and 2.5 times higher in patients with OA versus without in the respective populations [7,8]. These burdens showed substantial variation by joint location with hip OA incurring the highest costs primarily due to all-cause inpatient costs [7].…”

Section: Introductionmentioning

confidence: 99%

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Pain severity and healthcare resource utilization in patients with osteoarthritis in the United States

Nalamachu¹,

Robinson

Viktrup

et al. 2020

Postgraduate Medicine

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Objective: To evaluate healthcare resource utilization (HCRU) by osteoarthritis (OA) pain severity. Methods: Cross-sectional surveys of US physicians and their patients were conducted between February and May 2017. Using the Numeric Rating Scale, patients were classified by self-reported pain intensity in the last week into mild (0-3), moderate (4-6), and severe (7-10) cohorts. Parameters assessed included clinical characteristics, HCRU, and current caregiver support. Descriptive statistics were obtained, and analysis of variance and chi-square tests were performed. Results: Patients (n = 841) were mostly female (60.9%) and white (77.8%), with mean age of 64.6 years. Patients reported mild (45.4%), moderate (35.9%), and severe (18.7%) OA pain. Mean number of affected joints varied by pain severity (range mild: 2.7 to severe: 3.6; p < 0.0001). Pain severity was associated with an increased number of physician-reported and patient-reported overall healthcare provider visits (HCPs; both p < 0.001). As pain increased, patients reported an increased need for mobility aids, accessibility modifications to homes, and help with daily activities due to functional disability. The number of imaging tests used to diagnose OA was similar across pain severity but varied when used for monitoring (X-rays: p < 0.0001; computerized tomography scans: p < 0.0447). Hospitalization rates for OA were low but were significantly associated with pain severity (mild: 4.9%; severe: 11.5%). Emergency department visits were infrequent but increasing pain severity was associated with more prior and planned surgeries. Conclusion: Greater current pain was associated with more prior HCRU including imaging for monitoring progression, HCP visits including more specialty care, hospitalizations, surgery/planned surgery, and loss of independence due to functional disability. Yet rates of hospitalizations and X-ray use were still sizable even among patients with mild pain. These cross-sectional findings warrant longitudinal assessment to further elucidate the impact of pain on HCRU.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pain severity and healthcare resource utilization in patients with osteoarthritis in the United States

Nalamachu¹,

Robinson

Viktrup

et al. 2020

Postgraduate Medicine

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“…Total joint replacement (TJR) continues to be one of the most successful surgical interventions as evidenced by consistent pain relief and restoration of physical function and quality of life in patients with advanced osteoarthritis (OA) 1 . The lifetime risk of undergoing TJR surgery for the 13% of adults (approximately 31 million population) in the United States (US) diagnosed with OA of the hip and knee is steadily increasing alongside total episode costs associated with these procedures (estimated at $45 billion per annum) 2–4 . Based on current trends, procedural volumes and levels of spending seem only set to escalate for the 78 million American adults (26%) projected to experience hip and knee OA by 2040 5–8 …”

Section: Introductionmentioning

confidence: 99%

Advanced decision‐making using patient‐reported outcome measures in total joint replacement

Jayakumar

Bozic

2020

Journal Orthopaedic Research

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Up to one‐third of total joint replacement (TJR) procedures may be performed inappropriately in a subset of patients who remain dissatisfied with their outcomes, stressing the importance of shared decision‐making. Patient‐reported outcome measures capture physical, emotional, and social aspects of health and wellbeing from the patient's perspective. Powerful computer systems capable of performing highly sophisticated analysis using different types of data, including patient‐derived data, such as patient‐reported outcomes, may eliminate guess work, generating impactful metrics to better inform the decision‐making process. We have created a shared decision‐making tool which generates personalized predictions of risks and benefits from TJR based on patient‐reported outcomes as well as clinical and demographic data. We present the protocol for a randomized controlled trial designed to assess the impact of this tool on decision quality, level of shared decision‐making, and patient and process outcomes. We also discuss current concepts in this field and highlight opportunities leveraging patient‐reported data and artificial intelligence for decision support across the care continuum.

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“… 3 , 4 In addition, the economic burden of OA is shown by high healthcare costs and high indirect costs. 5 …”

Section: Introductionmentioning

confidence: 99%

Setting up distinctive outcome measures for each osteoarthritis phenotype

Roman‐Blas

Mendoza-Torres²,

Largo

et al. 2020

Therapeutic Advances in Musculoskeletal

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Osteoarthritis (OA) is an evolving chronic joint disease with a huge global impact. Given the intricate nature of the etiopathogenesis and subsequent high heterogeneity in the clinical course of OA, it is crucial to discriminate between etiopathogenic endotypes and clinical phenotypes, especially in the early stages of the disease. In this sense, we propose that an OA phenotype should be properly assessed with a set of outcome measures including those specifically related to the main underlying pathophysiological mechanisms. Thus, each OA phenotype can be related to different and clinically meaningful outcomes. OA phenotyping would lead to an adequate patient stratification in well-designed clinical trials and the discovery of precise therapeutic approaches. A significant effort will be required in this field in light of inconclusive results of clinical trials of tissue-targeting agents for the treatment of OA.

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Clinical, humanistic, and economic burden of osteoarthritis among noninstitutionalized adults in the United States

Cited by 113 publications

References 22 publications

Pain severity and healthcare resource utilization in patients with osteoarthritis in the United States

Pain severity and healthcare resource utilization in patients with osteoarthritis in the United States

Advanced decision‐making using patient‐reported outcome measures in total joint replacement

Setting up distinctive outcome measures for each osteoarthritis phenotype

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