A Longitudinal Study of the Association of Opioid Use with Change in Pain Interference and Functional Limitations in a Nationally Representative Cohort of Adults with Osteoarthritis in the United States

Shah, Drishti; Zhao, Xiaohui; Wei, Wenhui; Gandhi, Kavita; Dwibedi, Nilanjana; Webster, Lynn R.; Sambamoorthi, Usha

doi:10.1007/s12325-019-01200-4

Cited by 14 publications

(21 citation statements)

References 31 publications

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“…Therefore, selection of pain control agents and finding the relevant biological indicators are important in the treatment of OA. Up to the present time, many studies have focused on treatments for the chronic pain caused by OA, in the hope that a pain-relieving strategy will improve the symptoms and the daily functioning in these patients [4][5][6]. In addition, an increasing number of studies are focusing on related biological or proteomic changes in pain conditions to determine either the pain indicators or pain control targets.…”

Section: Introductionmentioning

confidence: 99%

TGF-β1 in plasma and cerebrospinal fluid can be used as a biological indicator of chronic pain in patients with osteoarthritis

et al. 2022

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Introduction Previous studies have demonstrated that cytokines, transforming growth factor (TGF-β1), and brain-derived neurotrophic factor (BDNF) can impact the intensity of pain in rodents. However, the roles of cytokines, TGF-β1 and BDNF in humans with chronic pain in osteoarthritis remains unclear, and no comparison between plasma and central cerebral spinal fluid (CSF) has been conducted. Methods Patients with osteoarthritis who were scheduled to receive spinal anesthesia were enrolled. The intensity of pain was evaluated with a visual analogue scale (VAS). In addition, patients with genitourinary system (GU) diseases and without obvious pain (VAS 0–1) were included as a comparison (control) group. The levels of TGF-β1, BDNF, tumor necrosis factor-α (TNF-α), and interleukin (IL)-8 within the CSF and plasma were collected and evaluated before surgery. Results The plasma and CSF TGF-β1 levels were significantly lower in the osteoarthritis patients with pain (VAS ≥ 3) than in the GU control patients. Downregulation of plasma BDNF was also found in osteoarthritis patients with pain. The Spearman correlation analysis showed that the VAS pain scores were significantly negatively correlated with the levels of TGF-β1 in the CSF of patients with osteoarthritis. However, there was no significant correlations between the pain scores and the levels of BDNF, TNF-α, and IL-8 in either the CSF or plasma. Conclusions TGF-β1 but not BDNF, TNF-α, or IL-8 may be an important biological indicator in the CSF of osteoarthritis patients with chronic pain.

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Section: Introductionmentioning

confidence: 99%

TGF-β1 in plasma and cerebrospinal fluid can be used as a biological indicator of chronic pain in patients with osteoarthritis

et al. 2022

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“…45 Treatment guidelines generally recommend against the use of opioids in patients with OA due to limited evidence of a positive impact on pain or function; however, treatment options are limited. 16 – 27 , 46 A major finding from our study was that, across cohorts, opioid use was associated with significantly higher number of estimated disability days and payments of all types. The magnitude of the differences exceeded those between cohorts (2.4- and 2.2-times higher WC days and payments; 5.5- and 7.2-times higher STD days and payments; 2.1-times healthcare payments).…”

Section: Discussionmentioning

confidence: 59%

A Retrospective Cohort Analysis of the Impact of Osteoarthritis on Disability Leave, Workers’ Compensation Claims, and Healthcare Payments

Thakkar¹,

Gifford²,

Sell³

et al. 2021

Journal of Occupational &Amp; Environmental Medicine

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Objectives: Examine short-term disability (STD) and workers’ compensation (WC) associated leave and wage replacements, and overall direct healthcare payments, among employees with osteoarthritis (OA) versus other chronically painful conditions; quantifying the impact of opioid use. Methods: Analysis of employees with more than or equal to two STD or WC claims for OA or pre-specified chronically painful conditions (control) in the IBM MarketScan Research Databases (2014 to 2017). Results: The OA cohort ( n = 144,355) had an estimated +1.2 STD days, +$152 STD payments, and +$1410 healthcare payments relative to the control cohort ( n = 392,639; P < 0.001). WC days/payments were similar. Differences were partially driven by an association between opioid use, increased STD days/payments, and healthcare payments observed in pooled cohorts ( P < 0.001). Conclusions: OA is associated with high STD days/payments and healthcare payments. Opioid use significantly contributes to these and this should be considered when choosing treatment.

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“…Research aiming to demonstrate that individuals with OA are more likely to experience impairment in their ability to perform activities of daily living has been seen previously, but in selected populations and mainly on patients with OA in speci c health settings or on waiting lists for joint replacement [17][18][19][20]. Recently, persistent opioid users were found to be more likely than non-users to report limitations in IADLs and physical, social, and cognitive functioning in follow-up [42]. Our analysis is also consistent with data regarding poorer patient functioning in BADLs, IADLs, and social functioning in subjects using analgesic drugs, although the ENSE survey was not able to identify active substances in analgesic agents used by patients.…”

Section: Discussionmentioning

confidence: 99%

Patient self-reported functioning by pain severity and usual analgesic treatment among older adults with osteoarthritis: analysis of the 2017 Spanish National Health Survey

et al. 2021

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BackgroundOsteoarthritis (OA) pain is among the leading causes of disability and social isolation worldwide. Since prevalence is high, particularly in adults aged 65 or older, it represents a signi cant burden for society and national health systems. The objective of this study was to determine whether patient self-reported functioning in key domains of daily living differs by pain severity and analgesic treatment among older OA patients in Spain. MethodsThe Spanish National Health Survey (ENSE), a large, nationally representative, cross-sectional general health survey administered by trained interviewers to 23,089 adults, was the data source. Subjects of both sexes aged 65 or older with a self-reported physician diagnosis of OA who completed the survey were analyzed. Patients were cross classi ed by pain severity (no/mild, moderate or severe) and analgesia (treated or untreated). Assessment of daily living included basic and instrumental activities of daily living and mental, social, and cognitive domains. Scores were re-scaled to a 0%-100% standardized metric (0%: no limitation [independence]; 100%: complete limitation [full dependence]). ResultsA total of 3,526 (3,389 surveys completed [96.1%]) older adults with OA were analyzed (women 73.3%; age 77.4 [standard deviation {SD}: 7.5]). Adjusted means (95% con dence interval [CI]) scores in domains of functioning showed signi cant association with pain severity (p < 0.001) but not treatment status, except basic and instrumental activities and social functioning, with higher scores in treated patients. Limitations in patients with untreated no/mild pain versus severe treated pain were as follows: in basic activities, 6.5% (5.0-8.0) versus 31.5% (30.1-32.9); in instrumental activities, 9.

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A Longitudinal Study of the Association of Opioid Use with Change in Pain Interference and Functional Limitations in a Nationally Representative Cohort of Adults with Osteoarthritis in the United States

Cited by 14 publications

References 31 publications

TGF-β1 in plasma and cerebrospinal fluid can be used as a biological indicator of chronic pain in patients with osteoarthritis

TGF-β1 in plasma and cerebrospinal fluid can be used as a biological indicator of chronic pain in patients with osteoarthritis

A Retrospective Cohort Analysis of the Impact of Osteoarthritis on Disability Leave, Workers’ Compensation Claims, and Healthcare Payments

Patient self-reported functioning by pain severity and usual analgesic treatment among older adults with osteoarthritis: analysis of the 2017 Spanish National Health Survey

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