Prevalence and treatment of hip and knee osteoarthritis in people aged 60 years or older in Germany: an analysis based on health insurance claims data

Abstract

ObjectiveOsteoarthritis (OA) is highly prevalent throughout the world, especially in the elderly population, and is strongly associated with patients’ frailty. However, little is known about the prevalence and treatment of OA in elderly patients in routine clinical care in Germany.Materials and methodsAs a part of Linking Patient-Reported Outcomes with CLAIms Data for Health Services Research in Rheumatology (PROCLAIR), a cross-sectional study using claims data from a large Germany statutory health insurance (BARMER) was conducted. We included people aged 60 years or older and assessed the prevalence of OA of the hip or knee, defined as having outpatient diagnoses (ICD: M16 or M17) in at least two quarters of 2014. The use of conservative treatment, including analgesics and physical therapy, and total joint replacement was studied. Analyses were stratified by age, sex, comorbidities, and level of care dependency defined by social law.ResultsA total of 595,754 patients (mean age: 74.9 years; 69.8% female) were diagnosed with OA (21.8%), with the highest prevalence in those between 80 and 89 years (31.0%) and in females compared to males (23.9% vs 18.3%). Prevalence decreased with increasing level of care dependency from 30.5% in patients with a low level (0/1) to 18.7% in the highest level of care dependency. A total of 63.4% of the patients with OA received analgesics, with higher use with increasing age. Physical therapy was prescribed to 43.1% of the patients, but use decreased with age. In all, 5.3% of the patients received total joint replacement in 2014.ConclusionThe lower frequency of coded OA with increasing level of care dependency may reflect underdiagnosis, and patients with many other medical problems seem to be at risk for inadequate recognition and treatment of their OA.

Retracted: GABARAP promotes bone marrow mesenchymal stem cells‐based the osteoarthritis cartilage regeneration through the inhibition of PI3K/AKT/mTOR signaling pathway

“…Osteoarthritis (OA) is a common chronic disease of the joints primarily affecting the middle‐aged and older individuals. Currently, 15% of the global population is afflicted with OA (Postler et al, ; World Health Organization, ). It is characterized by articular cartilage degeneration resulting from the loss of extra cellular matrix (ECM), extensive fibrosis and formation of fissures, ultimately leading to the complete loss of the cartilage surface (Lu et al, ).…”

Path model of factors influencing health‐related quality of life among older people with knee osteoarthritis

“…Musculoskeletal conditions have an impact on the health of more than 6.8% of the world's population (Wittenauer, Smith, & Aden, ). Knee osteoarthritis (OA) is the most common, with a prevalence of between 3.8 and 31%, depending on region, age, and sex, and its prevalence increases with age (Cross et al, ; Postler et al, ). Of the 291 conditions examined in the Global Burden of Disease Study 2010, hip and knee conditions were ranked the 11th highest cause of global disability and the 38th highest in terms of disability‐adjusted life years (Cross et al, ).…”

Reality of care for musculoskeletal diseases at the population level

“…But there is also evidence that certain diseases are underdiagnosed. These include OA in people with high levels of care and depression in axSpA patients [16,19].…”

“…Entzündlich rheumatische Erkrankungen · Therapie · Krankheitslast · Abrechnungsdaten · Versorgungsdefizite live in their own homes or in nursing homes. Postler et al [16] examined the prevalence of the diagnosis of hip and/or knee OA in persons over 60 years of age on the basis of the claims data. The frequency of hip and/or knee OA was highest in the group of 80-89 year olds (31%) and decreased again for older insured persons, also with increasing care level (31% for patients with care level 0 or 1 and 19% for patients with care level 3).…”