Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 26;7(1):e001023.
doi: 10.1136/bmjsem-2020-001023. eCollection 2021.

Impact of chronic Achilles tendinopathy on health-related quality of life, work performance, healthcare utilisation and costs

Tjerk S O Sleeswijk Visser  1   2 , Arco C van der Vlist  1 , Robert F van Oosterom  3 , Peter van Veldhoven  3 , Jan A N Verhaar  1 , Robert-Jan de Vos  1
Affiliations

Impact of chronic Achilles tendinopathy on health-related quality of life, work performance, healthcare utilisation and costs

Tjerk S O Sleeswijk Visser et al. BMJ Open Sport Exerc Med. .

Abstract

Objectives: To evaluate the impact of Achilles tendinopathy (AT) on quality of life (QoL), work performance, healthcare utilisation and costs in adults with conservatively treated chronic midportion AT.

Methods: This cross-sectional survey-based study included 80 patients and took place in a sports medicine department of a large regional hospital in the Netherlands. Data were collected before any intervention was given. Primary outcome was the EuroQol questionnaire (EQ-5D). The EQ-5D expresses the percentage of moderate/major problems on the domains self-care, anxiety/depression, mobility, usual activities and pain/discomfort. Secondary outcomes were the number of previous healthcare visits, work performance during the period of symptoms and estimated annual direct medical and indirect costs per patient as a result of AT.

Results: All 80 patients completed the questionnaires. The EQ-5D scores were low for the domains self-care (1%) and anxiety/depression (20%), and high for the domains mobility (66%), usual activities (50%) and pain/discomfort (89%). Patients with AT mainly reported an impact on work productivity (38%). Work absenteeism due to AT was present in 9%. The total median (IQR) number of annual healthcare visits was 9 (3-11). The total mean (SD) estimated annual costs were €840 (1420) per patient with AT (mean (SD) US$991 (1675)).

Conclusions: This study shows the large impact of AT on QoL and work productivity. This study also provides new information about the socioeconomic impact of AT, which emphasises that this common and longstanding disease causes substantial costs. These findings stress the need for optimised treatment and improved preventive interventions for AT.

Trial registration number: NCT02996409.

Keywords: Achilles; economics; quality of life; sociology; tendinosis.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The EQ-5D scores for persons with musculoskeletal diseases per domain. DMC3 study. Displayed values are percent with any (moderate and severe) problems (SE). EQ-5D: EuroQoL five-item questionnaire for measuring health-related quality of life. General population: EQ-5D score in a large sample of the general population (no target on specific diseases) aged ≥25 years (n=3664), weighted for age and sex in the Dutch population of 1998. DMC3 study, Dutch population-based musculoskeletal complaints and consequences cohort study.
See this image and copyright information in PMC

References

    1. d'Hooghe P, Kerkhoffs G. The ankle in football. 1 edn. Springer series Sports and Traumatology, 2014.
    1. Maffulli N, Sharma P, Luscombe KL. Achilles tendinopathy: aetiology and management. J R Soc Med 2004;97:472–6. 10.1177/0141076809701004 - DOI - PMC - PubMed
    1. Maffulli N, Khan KM, Puddu G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy 1998;14:840–3. 10.1016/S0749-8063(98)70021-0 - DOI - PubMed
    1. Scott A, Squier K, Alfredson H, et al. . Icon 2019: international scientific tendinopathy symposium consensus: clinical terminology. Br J Sports Med 2020;54:260–2. 10.1136/bjsports-2019-100885 - DOI - PubMed
    1. de Jonge S, van den Berg C, de Vos RJ, et al. . Incidence of midportion Achilles tendinopathy in the general population. Br J Sports Med 2011;45:1026–8. 10.1136/bjsports-2011-090342 - DOI - PubMed

Associated data

LinkOut - more resources