Socioeconomic inequalities in knee pain, knee osteoarthritis, and health-related quality of life: a population-based cohort study in southern Sweden

Kiadaliri, Aliasghar Ahmad; Verdier, Maria Gerhardsson de; Turkiewicz, Aleksandra; Lohmander, L. Stefan; Englund, Martin

doi:10.1080/03009742.2016.1181203

Cited by 41 publications

(35 citation statements)

References 52 publications

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“…Our findings that participants with lower educational attainment reported more pain and lower HRQoL at baseline and maintained a higher willingness to undergo joint surgery despite participation in the BOA self-management program is in line with earlier research [11,14,24].…”

Section: Discussionsupporting

confidence: 92%

“…Disparities in the patient reported frequency of OA-related symptoms and self-efficacy to manage symptoms have previously been reported in the Swedish context based on social determinants, such as educational level and domestic/foreign birthplace [10][11][12]. A recently published study by Kiadaliri and colleagues [11] found that Swedish residents diagnosed with knee OA who had lower educational levels had more frequent pain and worse health-related quality of life (HRQoL) than those with a higher educational level. Higher odds of symptomatic or radiologically confirmed OA as well as willingness to undergo TJR have been confirmed internationally in those with lower education [13,14].…”

Section: Introductionmentioning

confidence: 97%

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Sociodemographic Inequalities in Outcomes of a Swedish Nationwide Self-Management Program for Osteoarthritis: Results from 22,741 Patients between Years 2008–2017

Unevik

Abbott

Fors

et al. 2020

JCM

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The aim of this study is to investigate if there are educational level and birthplace related differences in joint-related pain, health-related quality of life (HRQoL), willingness to undergo joint surgery, walking difficulties, physical activity level, fear-avoidance behavior before, as well as three and 12 months after participation in a structured self-management program for hip and knee osteoarthritis. Differences in adherence to and use of knowledge from the program were also investigated. An observational national register-based study was performed with a prospective longitudinal design using patient and physiotherapist-reported data on 22,741 complete cases from the National Quality Register for better management of patients with osteoarthritis (BOA) during years 2008–2017. At baseline and after three and 12 months follow-up, higher educational level and being domestic-born was associated with less joint-related pain, better HRQoL, lower willingness to undergo joint surgery, fewer walking difficulties, higher physical activity level, and less fear-avoidance behavior. Foreign born individuals demonstrated higher adherence to exercise and reported better use of the self-management program. The BOA self-management program may require further pedagogical refinement to suit participants of different sociodemographic backgrounds and health literacy. A more patient-centered delivery, sensitive to educational, ethnic, and cultural differences may potentially reduce inequalities in future outcomes.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 97%

Sociodemographic Inequalities in Outcomes of a Swedish Nationwide Self-Management Program for Osteoarthritis: Results from 22,741 Patients between Years 2008–2017

Unevik

Abbott

Fors

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Subjects with pain in one or both knees in the past 12 months and duration of minimum 1 month were classified as having knee pain. In the second stage of the MOA, a random sample of 1 300 subjects with knee pain and 650 subjects without knee pain were invited to a clinical visit and radiographic examination [ 13 ]. A total of 1 527 subjects participated in the second stage and responded to the EuroQol-5D-3L (EQ-5D-3L) and the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaires.…”

Section: Methodsmentioning

confidence: 99%

Assessing the external validity of algorithms to estimate EQ-5D-3L from the WOMAC

Kiadaliri

Englund

2016

Health Qual Life Outcomes

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BackgroundThe use of mapping algorithms have been suggested as a solution to predict health utilities when no preference-based measure is included in the study. However, validity and predictive performance of these algorithms are highly variable and hence assessing the accuracy and validity of algorithms before use them in a new setting is of importance. The aim of the current study was to assess the predictive accuracy of three mapping algorithms to estimate the EQ-5D-3L from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) among Swedish people with knee disorders. Two of these algorithms developed using ordinary least squares (OLS) models and one developed using mixture model.MethodsThe data from 1078 subjects mean (SD) age 69.4 (7.2) years with frequent knee pain and/or knee osteoarthritis from the Malmö Osteoarthritis study in Sweden were used. The algorithms’ performance was assessed using mean error, mean absolute error, and root mean squared error. Two types of prediction were estimated for mixture model: weighted average (WA), and conditional on estimated component (CEC).ResultsThe overall mean was overpredicted by an OLS model and underpredicted by two other algorithms (P < 0.001). All predictions but the CEC predictions of mixture model had a narrower range than the observed scores (22 to 90 %). All algorithms suffered from overprediction for severe health states and underprediction for mild health states with lesser extent for mixture model. While the mixture model outperformed OLS models at the extremes of the EQ-5D-3D distribution, it underperformed around the center of the distribution.ConclusionsWhile algorithm based on mixture model reflected the distribution of EQ-5D-3L data more accurately compared with OLS models, all algorithms suffered from systematic bias. This calls for caution in applying these mapping algorithms in a new setting particularly in samples with milder knee problems than original sample. Assessing the impact of the choice of these algorithms on cost-effectiveness studies through sensitivity analysis is recommended.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-016-0547-y) contains supplementary material, which is available to authorized users.

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“…Many elderly OA patients visit pain clinics or hospitals, and knee and hip OA were reportedly the third most prevalent musculoskeletal disorder . OA causes pain and is associated with physical disability . Both pain and physical disability cause a decline in the quality of life and also affect psychological health.…”

Section: Introductionmentioning

confidence: 99%

Association between osteoarthritis and mental health in a Korean population: a nationwide study

et al. 2017

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Socioeconomic inequalities in knee pain, knee osteoarthritis, and health-related quality of life: a population-based cohort study in southern Sweden

Abstract: In Sweden there are socioeconomic gradients related to both FKP and knee OA as well as HRQoL in favour of people with better SES. SES should be taken into account in health resource allocation pertaining to knee-related disorders.

Cited by 41 publications

References 52 publications

Sociodemographic Inequalities in Outcomes of a Swedish Nationwide Self-Management Program for Osteoarthritis: Results from 22,741 Patients between Years 2008–2017

Sociodemographic Inequalities in Outcomes of a Swedish Nationwide Self-Management Program for Osteoarthritis: Results from 22,741 Patients between Years 2008–2017

Assessing the external validity of algorithms to estimate EQ-5D-3L from the WOMAC

Association between osteoarthritis and mental health in a Korean population: a nationwide study

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