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. 2023 Aug 19;5(4):100403.
doi: 10.1016/j.ocarto.2023.100403. eCollection 2023 Dec.

Prognostic value of illness perception on changes in knee pain among elderly individuals: Two-year results from the Frederiksberg Cohort study

Elisabeth Ginnerup-Nielsen  1 , Robin Christensen  1   2 , Berit L Heitmann  1   3 , Roy D Altman  4 , Lyn March  5 , Anthony Woolf  6 , Henning Bliddal  1 , Marius Henriksen  1
Affiliations

Prognostic value of illness perception on changes in knee pain among elderly individuals: Two-year results from the Frederiksberg Cohort study

Elisabeth Ginnerup-Nielsen et al. Osteoarthr Cartil Open. .

Abstract

Objective: To investigate the prognostic value of illness perception (IP) on knee pain, quality of life (QoL) and functional level in elderly individuals reporting knee pain.

Design: A prospective cohort study of 1552 elderly with knee pain comparing two previously established clusters based on the Brief Illness Perception questionnaire. Cluster 1 ("Concerned optimists" [hypothesized unfavorable profile]; n ​= ​642) perceived their knee pain as a greater threat to them than Cluster 2 ("Unconcerned confident" [hypothesized favorable profile]; n ​= ​910). Primary outcome was the change from baseline to year 2 in the KOOS Pain subscale. Secondary outcomes were changes from baseline in quality of life (EuroQol-5 Domain and EQ VAS) and in the KOOS subscales Symptom, Activities of Daily Living, Knee-related QoL and Sports and recreation. Analyses were done on the original Intention-To-Survey (ITS) population, using repeated measures mixed linear models.

Results: Among the ITS population, 841 (54%) responded to the 2-year survey. There was a statistically significant but clinically irrelevant cluster difference in the 2-year change from baseline in KOOS pain (mean difference: 6.0 KOOS points [95% CI: 7.3 to -4.7]) explained by a minor improvement in Cluster 1: (6.2 points) and no changes in Cluster 2: (0.2 points). Comparable results were found across the secondary outcomes. Clinically irrelevant cluster changes in IP were seen.

Conclusion: In a cohort of people with knee pain, IP phenotype (i.e., Clusters) were of no prognostic value for the 2-year changes in pain, function, and QoL. Targeting IP may not be relevant in this patient population.

Trial registration number and date of registration: The Frederiksberg Cohort study was pre-registered at clinicaltrials.gov (NCT03472300) on March 21, 2018.

Keywords: Cluster analyses; Cohort study; Illness perception; Knee pain; Prognostic factors; Quality of life.

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Conflict of interest statement

All authors have completed the Osteoarthritis and Cartilage Open authors’ disclosure form and declare that they have no competing interests to report.

Figures

Fig. 1
Fig. 1
The Frederiksberg Cohort study comparing two illness perception phenotypes over time.
Fig. 2
Fig. 2
Trajectories of knee pain and health related quality of life. Measures based on least squares means (SE). KOOS: Knee Injury and Osteoarthritis Outcome Score, higher scores denote higher functional level. EQ-5D (EuroQol-5 Domain), higher scores denote better quality of life.
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