Sick Leave and Costs in Active Workers With Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study

Abstract

ObjectiveTo evaluate sick leave and its costs in active workers who initiate opioid treatment for moderate/severe chronic osteoarthritis (OA) pain.MethodsSecondary analysis of the longitudinal, retrospective OPIOIDS study using electronic medical records (EMR) of patients aged ≥ 18 years who started opioid treatment for chronic OA pain between 2010 and 2015 after treatment failure with usual analgesics. The follow-up period was 36 months from the index date, and the days of sick leave and their cost were analyzed.ResultsA total of 5,089 EMRs of OA chronic pain patients aged 56.8 years (SD: 4.6), 56.6% male, were analyzed: 73.3% of patients started treatment with a weak opioid and 26.7% a strong opioid. At 36 months, adherence was 21% (strong opioids 15.4%, weak opioids: 23%; p<0.001), and 77% of patients had at least one sick leave related with OA chronic pain, with a mean total days off work of 93 days in all actively working patients (120.5 days in patients with sick leaves). In 16.9% it lasted ≥ 6 months. Pain reduction was modest (-1.2 points; -4.0%, p<0.001). The cost of sick leave was € 2,594 patient/year and was associated (p<0.05) with age (β-0.043), female sex (β-0.035), comorbidity (β-0.034) and strong opioid use (β-0.037).ConclusionsActive workers who started opioid treatment for chronic osteoarthritis pain showed an increased frequency of sick leave and cost to society, with modest pain reduction. Age, female sex, comorbidity, and strong opioids were factors associated with the cost of sick leave.