Health-related quality of life and costs in patients with osteoarthritis on waiting list for total knee replacement

• Published in: Osteoarthritis and cartilage Vol. 15; no. 3; pp. 258 - 265
• Main Authors: Núñez, M., Ph.D, Núñez, E., Ph.D, Segur, J.M., M.D, Maculé, F., M.D, Sanchez, A., Ph.D, Hernández, M V., M.D, Vilalta, C., M.D
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2007
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee; Costs; Cross-Sectional Studies; Female; Health Care Costs; Health Status; Humans; Male; Middle Aged; Osteoarthritis; Osteoarthritis, Knee - economics; Osteoarthritis, Knee - psychology; Quality of Life; Rheumatology; Severity of Illness Index; Surveys and Questionnaires; Waiting list; Waiting Lists; Costs; Waiting list; Osteoarthritis; Quality of life
• ISSN: 1063-4584; 1522-9653
• DOI: 10.1016/j.joca.2006.07.011

Summary Objectives To determine: (1) health-related quality of life (HRQL) in patients with severe osteoarthritis (OA) on a waiting list (WL) for total knee replacement (TKR) and to compare it with general Spanish reference population values (RPVs); (2) the influence of sociodemographic and clinical variables on HRQL dimensions and (3) the use and cost of resources related to knee OA. Methods Cross-sectional study. HRQL was measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Medical Outcomes Study 36 Item Short Form Health Survey (SF-36) questionnaires. Sociodemographic and disease characteristics, body mass index, pharmacological treatment and the cost and use of economic resources related to knee OA during the 6-months previous to baseline were recorded. Relationships were analyzed using linear regression models. Results One hundred consecutive outpatients (71 female, mean age 71 ± 6.89 years, mean disease duration 11.84 ± 10.52 years) were included. Patients showed worse HRQL measured by SF-36 than the reference population, mainly in physical function, physical role and bodily pain dimensions ( P < 0.05). A low number of visits to physicians were recorded (mean 0.62 ± 1.04). Total mean direct medical costs were 200.24 € (95%CI 167.08–233.40) and total mean direct non-medical costs were 1234.87 € (95%CI 812.74–1657.00). Conclusions The HRQL of patients on a WL is worse than that of the reference population. The main costs of these patients were on non-medical resources, mainly due to functional limitations and loss of autonomy. The results suggest little compliance with knee OA management guidelines.