Observational Study

. 2015 Feb;54(2):270-7.

doi: 10.1093/rheumatology/keu332. Epub 2014 Aug 23.

Inadequate pain relief and large functional loss among patients with knee osteoarthritis: evidence from a prospective multinational longitudinal study of osteoarthritis real-world therapies

Affiliations

¹ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK, Clinical Development, MRL, Merck & Co., Kenilworth, Global Health Outcomes, Merck & Co., Whitehouse Station, MedData Analytics, East Brunswick, NJ, College of Pharmacy, St Johns University, Queens, NY, USA, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Centre for Health Economics, Swansea University, Swansea, UK, Cochin Hospital, Rehabilitation Department, University of Paris, Paris, France, Department of Rheumatology and Clinical Immunology, University of Twente, Enschede, The Netherlands and Pain Research & Nuffield Department of Anaesthetics, Oxford University, Oxford, UK. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK, Clinical Development, MRL, Merck & Co., Kenilworth, Global Health Outcomes, Merck & Co., Whitehouse Station, MedData Analytics, East Brunswick, NJ, College of Pharmacy, St Johns University, Queens, NY, USA, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Centre for Health Economics, Swansea University, Swansea, UK, Cochin Hospital, Rehabilitation Department, University of Paris, Paris, France, Department of Rheumatology and Clinical Immunology, University of Twente, Enschede, The Netherlands and Pain Research & Nuffield Department of Anaesthetics, Oxford University, Oxford, UK.
² Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK, Clinical Development, MRL, Merck & Co., Kenilworth, Global Health Outcomes, Merck & Co., Whitehouse Station, MedData Analytics, East Brunswick, NJ, College of Pharmacy, St Johns University, Queens, NY, USA, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Centre for Health Economics, Swansea University, Swansea, UK, Cochin Hospital, Rehabilitation Department, University of Paris, Paris, France, Department of Rheumatology and Clinical Immunology, University of Twente, Enschede, The Netherlands and Pain Research & Nuffield Department of Anaesthetics, Oxford University, Oxford, UK.
³ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK, Clinical Development, MRL, Merck & Co., Kenilworth, Global Health Outcomes, Merck & Co., Whitehouse Station, MedData Analytics, East Brunswick, NJ, College of Pharmacy, St Johns University, Queens, NY, USA, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Centre for Health Economics, Swansea University, Swansea, UK, Cochin Hospital, Rehabilitation Department, University of Paris, Paris, France, Department of Rheumatology and Clinical Immunology, University of Twente, Enschede, The Netherlands and Pain Research & Nuffield Department of Anaesthetics, Oxford University, Oxford, UK. stephanie_taylor@merck.com.

PMID: 25150513
PMCID: PMC4301711
DOI: 10.1093/rheumatology/keu332

Observational Study

Inadequate pain relief and large functional loss among patients with knee osteoarthritis: evidence from a prospective multinational longitudinal study of osteoarthritis real-world therapies

Philip G Conaghan et al. Rheumatology (Oxford). 2015 Feb.

. 2015 Feb;54(2):270-7.

doi: 10.1093/rheumatology/keu332. Epub 2014 Aug 23.

Affiliations

¹ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK, Clinical Development, MRL, Merck & Co., Kenilworth, Global Health Outcomes, Merck & Co., Whitehouse Station, MedData Analytics, East Brunswick, NJ, College of Pharmacy, St Johns University, Queens, NY, USA, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Centre for Health Economics, Swansea University, Swansea, UK, Cochin Hospital, Rehabilitation Department, University of Paris, Paris, France, Department of Rheumatology and Clinical Immunology, University of Twente, Enschede, The Netherlands and Pain Research & Nuffield Department of Anaesthetics, Oxford University, Oxford, UK. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK, Clinical Development, MRL, Merck & Co., Kenilworth, Global Health Outcomes, Merck & Co., Whitehouse Station, MedData Analytics, East Brunswick, NJ, College of Pharmacy, St Johns University, Queens, NY, USA, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Centre for Health Economics, Swansea University, Swansea, UK, Cochin Hospital, Rehabilitation Department, University of Paris, Paris, France, Department of Rheumatology and Clinical Immunology, University of Twente, Enschede, The Netherlands and Pain Research & Nuffield Department of Anaesthetics, Oxford University, Oxford, UK.
² Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK, Clinical Development, MRL, Merck & Co., Kenilworth, Global Health Outcomes, Merck & Co., Whitehouse Station, MedData Analytics, East Brunswick, NJ, College of Pharmacy, St Johns University, Queens, NY, USA, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Centre for Health Economics, Swansea University, Swansea, UK, Cochin Hospital, Rehabilitation Department, University of Paris, Paris, France, Department of Rheumatology and Clinical Immunology, University of Twente, Enschede, The Netherlands and Pain Research & Nuffield Department of Anaesthetics, Oxford University, Oxford, UK.
³ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK, Clinical Development, MRL, Merck & Co., Kenilworth, Global Health Outcomes, Merck & Co., Whitehouse Station, MedData Analytics, East Brunswick, NJ, College of Pharmacy, St Johns University, Queens, NY, USA, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Centre for Health Economics, Swansea University, Swansea, UK, Cochin Hospital, Rehabilitation Department, University of Paris, Paris, France, Department of Rheumatology and Clinical Immunology, University of Twente, Enschede, The Netherlands and Pain Research & Nuffield Department of Anaesthetics, Oxford University, Oxford, UK. stephanie_taylor@merck.com.

PMID: 25150513
PMCID: PMC4301711
DOI: 10.1093/rheumatology/keu332

Abstract

Objective: To estimate the prevalence of inadequate pain relief (IPR) among patients with symptomatic knee OA prescribed analgesic therapy and to characterize patients with IPR.

Methods: Patients ≥50 years old with physician-diagnosed knee OA who had taken topical or oral pain medication for at least 14 days were recruited for this prospective non-interventional study in six European countries. Pain and function were assessed using the Brief Pain Inventory (BPI) and the WOMAC; quality of life (QoL) was assessed using the 12-item short form. IPR was defined as an average pain score of >4 out of 10 on BPI question 5.

Results: Of 1187 patients enrolled, 68% were female and the mean age was 68 years (s.d. 9); 639 (54%) met the definition of IPR. Patient responses for the BPI average pain question were well correlated with responses on the WOMAC pain subscale (Spearman r = 0.64, P < 0.001). In multivariate logistic regression, patients with IPR had greater odds of being female [adjusted odds ratio (adjOR) 1.90 (95% CI 1.46, 2.48)] and having OA in both knees [adjOR 1.48 (95% CI 1.15, 1.90)], higher BMI, longer OA duration, depression or diabetes. Patients with IPR (vs non-IPR) were more likely to have worse QoL, greater function loss and greater pain interference.

Conclusion: IPR is common among patients with knee OA requiring analgesics and is associated with large functional loss and impaired QoL. Patients at particular risk of IPR, as characterized in this study, may require greater attention towards their analgesic treatment options.

Trial registration: https://clinicaltrials.gov/ (NCT01294696).

Keywords: analgesic therapy; inadequate pain relief; knee; osteoarthritis.

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Figures

F<sc>ig</sc>. 1 — **Fig. 1**
Score distribution for the WOMAC pain subscale score (converted to a 0–10 scale) by score on BPI question 5 as IPR (score >4) and non-IPR (score ≤4) Percentages are patients in each cohort (IPR and non-IPR); 78 patients were missing WOMAC pain subscale data. IPR: inadequate pain relief; BPI: Brief Pain Inventory.

See this image and copyright information in PMC

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Inadequate pain relief and large functional loss among patients with knee osteoarthritis: evidence from a prospective multinational longitudinal study of osteoarthritis real-world therapies

Affiliations

Inadequate pain relief and large functional loss among patients with knee osteoarthritis: evidence from a prospective multinational longitudinal study of osteoarthritis real-world therapies

Authors

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Abstract

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References

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Grants and funding

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Medical

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