Disease burden on health care by pain severity and usual analgesic treatment in patients with symptomatic osteoarthritis: a Spanish nationwide health survey

Abstract

Objectives: To estimate disease burden on healthcare in osteoarthritis (OA) pain patients in Spain, and to determine whether frequency of healthcare resource utilisation (HRU) and related costs differ by pain severity and treatment with usual analgesics. Methods:The 2017 Spanish National Health Survey (ENSE), a large, nationwide, cross-sectional general health survey, was used to abstract data on adult patients with a self-reported physician diagnosis of OA. Patients were cross-classified according to pain severity in the last 4-weeks (no/mild, moderate, severe) and use of usual analgesia in the last 2-weeks (treated/untreated). Per patient per year (PPPY) HRU included medical visits, other healthcare visits, diagnostic/laboratory tests, days of hospitalisation, days in day hospital facilities, and surgical procedures. Costs were computed by multiplying unit price by annual frequency of HRU.Results: 5,234 OA patients were analysed (women 70.8%; age 69.9 [SD:13.1]; 66.5% treated). Significant associations were observed in treated and untreated OA patients between pain severity and adjusted PPPY mean utilisation of medical visits, days of hospitalisation, other healthcare visits, and related costs: the greater the pain severity, the greater the HRU and costs, with treated showing higher HRU and costs than untreated patients. Average total healthcare costs were €2,274 (5,461) PPPY, with costs associated with outpatient healthcare visits being the major driver.Conclusions: HRU and related costs were seen to increase as pain severity increased in patients with OA in a nationally representative sample in Spain. These findings seem to be more consistent in treated versus not treated patients with usual analgesics.

A Linear Decomposition Approach to Explain Excess Direct Healthcare Expenditures Associated with Pain Among Adults with Osteoarthritis

“…Previously, studies have reported significantly higher healthcare expenditures in adults with osteoarthritis compared to those without osteoarthritis 43 , 44 and higher expenditures due to pain. 19 , 20 In this study, we restricted our analysis to adults with osteoarthritis and examined excess healthcare expenditures associated with pain interference. We found that adults with osteoarthritis and pain had 2.01 times higher annual healthcare expenditures compared to those without pain.…”

“…It has been reported that healthcare expenditures were higher in adults with osteoarthritis and severe pain compared to those with moderate or no pain. 19 , 20 The presence of comorbidities may affect pain severity and contribute to the disease burden including higher healthcare expenditures among adults with osteoarthritis. 5 , 21 Thus, it is important to understand the factors that drive excess expenditures associated with pain among adults with osteoarthritis.…”

Randomised Clinical Trial to Analyse the Efficacy of Eggshell Membrane to Improve Joint Functionality in Knee Osteoarthritis

“…OA is the most prevalent joint disorder and source of chronic pain and disability in developed countries [ 5 , 6 ]. This degenerative disease of the joint affects the locomotor system and is characterised by a loss of articular cartilage, as well as an osseocartilaginous proliferation of the subchondral and articular margins [ 7 ].…”

Future projections of opioid use and cost in patients with chronic osteoarthritis pain in Spain

“…23 Likewise, OA exerts a significant impact on healthcare systems, given the substantial costs associated with joint replacement surgery, specialist consultation and the use of prescription medicines, amongst other resources, to manage moderate to severe pain. [19][20][21]24 In Spain, OA healthcare costs were on average €2274 per patient per year; projecting the actual prevalence of OA, 15 the actual national costs would be €11.2bn, or 0.96% of the 2017 Spanish gross domestic product. 24 On the other hand, there was a worldwide doubling in the use of opioids for pain relief between the years 2010 and 2019, with high levels of opioid use evident in developed Western countries.…”

“…[19][20][21]24 In Spain, OA healthcare costs were on average €2274 per patient per year; projecting the actual prevalence of OA, 15 the actual national costs would be €11.2bn, or 0.96% of the 2017 Spanish gross domestic product. 24 On the other hand, there was a worldwide doubling in the use of opioids for pain relief between the years 2010 and 2019, with high levels of opioid use evident in developed Western countries. [25][26][27][28] Opioids have the potential to cause harm, both short-and long-term, in all subjects 727,356 chronic OA pain patients per day; 41.8% on strong opioids.…”