Anticipated significant work limitation in primary care consulters with osteoarthritis: a prospective cohort study

Wilkie, Ross; Phillipson, Chris; Hay, Elaine M; Pransky, Glenn

doi:10.1136/bmjopen-2014-005221

Cited by 11 publications

(16 citation statements)

References 41 publications

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“…Individuals were considered to have osteoarthritis if, at that wave or at an earlier wave, they self-reported having been told by a doctor that they have osteoarthritis. (As a gradually progressive chronic condition, osteoarthritis will always remain present following self-reported doctor diagnosis 25 .) Arthritis of an unknown type was assumed to be osteoarthritis as this is the most common form of arthritis 26 .…”

Section: Methodsmentioning

confidence: 99%

Healthy working life expectancy at age 50 for people with and without osteoarthritis in local and national English populations

Lynch

Bucknall

Jagger

et al. 2022

Sci Rep

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Retirement ages are rising in many countries to offset the challenges of population ageing, but osteoarthritis is an age-associated disease that is becoming more prevalent and may limit capacity to work until older ages. We aimed to assess the impact of osteoarthritis on healthy working life expectancy (HWLE) by comparing HWLE for people with and without osteoarthritis from ages 50 and 65 nationally and in a local area in England. Mortality-linked data for adults aged ≥ 50 years were used from six waves (2002–13) of the English Longitudinal Study of Ageing and from three time points of the North Staffordshire Osteoarthritis Project. HWLE was defined as the average number of years expected to be spent healthy (no limiting long-standing illness) and in paid work (employment or self-employment), and was estimated for people with and without osteoarthritis and by sex and occupation type using interpolated Markov chain multi-state modelling. HWLE from age 50 years was a third lower for people with osteoarthritis compared to people without osteoarthritis both nationally (5.68 95% CI [5.29, 6.07] years compared to 10.00 [9.74, 10.26]) and in North Staffordshire (4.31 [3.68, 4.94] years compared to 6.90 [6.57, 7.24]). HWLE from age 65 years for self-employed people with osteoarthritis exceeded HWLE for people without osteoarthritis in manual or non-manual occupations. Osteoarthritis was associated with a significantly shorter HWLE. People with osteoarthritis are likely to have significantly impaired working ability and capacity to work until older ages, especially in regions with poorer health and work outcomes.

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Section: Methodsmentioning

confidence: 99%

Healthy working life expectancy at age 50 for people with and without osteoarthritis in local and national English populations

Lynch

Bucknall

Jagger

et al. 2022

Sci Rep

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“…Osteoarthritis (OA) is the most frequent joint disorder in western societies, and will presumably develop into one of the top-ranking causes of physical functional impairment and disability, including work-related disorders and absenteeism, during the next one or two decades [ 1 – 3 ]. Knee OA is a highly age and sex-associated prevalent and complex disease, with a substantial impact on the quality of life from pain and physical immobility, and consequently a significant limitation in social and working life [ 4 ]. Additionally, the co-morbidity associated with symptomatic knee OA is subject to concern because in a recent study an increased all-cause and disease-specific mortality has been reported in patients with symptomatic and radiographic hip and knee OA [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Sex differences in risk and heritability estimates on primary knee osteoarthritis leading to total knee arthroplasty: a nationwide population based follow up study in Danish twins

Skousgaard¹,

Skytthe²,

Möller³

et al. 2016

Arthritis Res Ther

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BackgroundSymptomatic knee osteoarthritis is a highly age and sex associated complex disease. Little is known about the causes behind this age and sex associated increase, or if genetic and environmental factors impacts differently by gender. Our study examined the risk and heritability of primary knee osteoarthritis leading to total knee arthroplasty and whether these differences were attributable to sex and age differences in heritability.MethodsAll twins of known zygosity from The Danish Twin Register alive in 1997 were examined in a nationwide population based follow-up study collecting information on all twins recorded in The Danish Knee Arthroplasty from 1997 to follow-up in 2010. Our main outcomes were the cumulative incidence, probandwise concordance rates, heritability, within pair correlations in monozygotic and dizygotic twin pairs and the genetic and environmental influence estimated in models taking into account that individuals may not have had a total knee arthroplasty at follow up.Results92,748 twins were eligible for analyses and 576 twins had a record of primary knee osteoarthritis in The Danish Knee Arthroplasty Register at follow-up comprising 358 female and 218 male twin cases. The risk increased particular after the age of 50 years displaying significant sex differences in the elderly. In the sex stratified analyses a discrete genetic component was found in females, but in males no genetic component could be detected. In both genders common and unique environmental factors were highly significant. In the sex-adjusted analysis an additive genetic component of 18 % (0; 62), a shared environmental component of 61 % (25; 97) and an individual environmental component of 21 % (6; 36) accounted for the variation in liability to primary total knee arthroplasty.ConclusionThe risk of primary total knee arthroplasty increases significantly after the age of 50 years, in particular in females, displaying significant sex differences in the elderly. After sex-adjustment 82 % of the variation in liability to primary total knee arthroplasty was attributable to common and unique environmental factors; the remaining 18 % of this variation was attributable to additive genetic factors indicating a pivotal impact of environmental factors on this disease.

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“…61,62 Wilkie and colleagues conducted interviews in 297 English working adults aged 50 to 65, who consulted primary care practitioners due to OA symptoms. 63 The authors concluded that OA was likely to be associated with a 3-fold increased likelihood of not being able to maintain a job. 62,63 A comparison between fiscal analysis and other burden of disease analyses is not straightforward, due to heterogeneity in the former and because they address different economic consequences of OA.…”

Section: Discussionmentioning

confidence: 99%

“…63 The authors concluded that OA was likely to be associated with a 3-fold increased likelihood of not being able to maintain a job. 62,63 A comparison between fiscal analysis and other burden of disease analyses is not straightforward, due to heterogeneity in the former and because they address different economic consequences of OA. A systematic review of burden of disease studies estimated that in European countries the annual direct health-care costs represented close to 20% (€1000/€5100) of total hip and knee OA burden.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Fiscal Consequences of Controlled and Uncontrolled Osteoarthritis Pain Applying a UK Public Economic Perspective

Kotsopoulos

Kließ

Beck

et al. 2021

JHEOR

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Background: Individuals experiencing osteoarthritis (OA) pain can pose significant costs for governments due to reduced work activity in these individuals and increasing reliance on public support benefits. In this analysis we capture the broader economic impact of OA pain by applying a government perspective, public economic framework to assess controlled and uncontrolled pain. Methods: We used a Markov model to compare labour market participation in people with uncontrolled OA hip or knee pain compared to a cohort with controlled OA pain. The likelihood of employment, long-term sickness, disability, and early retirement in those with controlled pain used publicly available UK data. The relative effect of uncontrolled OA pain on fiscal outcomes is drawn from peer reviewed publications reporting reduced work activity and reliance on public benefits for people with uncontrolled OA pain. Lost tax revenue was derived using UK tax rates and national insurance contributions applied to annual earnings. Social benefit rules were applied to calculate government financial support to individuals. Health-care costs were calculated based on estimates from an UK observational study. The base case analysis compared the projected lost tax revenue and transfer payments for a 50-year-old cohort with severe OA pain, retiring at age 65. Results: For a 50-year-old individual with moderate uncontrolled OA pain with 15-years remaining work expectancy, the model estimated a £62 383 reduction in employment earnings, a £24 307 reduction in tax contributions and a need for £16 034 in government benefits, compared to a person with controlled OA pain. In people with severe uncontrolled OA pain incremental foregone earnings were estimated to be £126 384, £44 925 were not paid through taxation and £25 829 were received in public benefits, compared to the controlled pain cohort. Health-care costs represented 13% and 12% of all OA-related fiscal cost in the moderate uncontrolled OA pain and severe uncontrolled OA pain comparison, respectively. Conclusions: For governments, maintaining an active workforce is paramount to maintaining economic growth and reducing spending on government programs. The approach described here can be used to augment cost-effectiveness models to inform a range of stakeholders of benefits attributed to controlled OA pain.

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Anticipated significant work limitation in primary care consulters with osteoarthritis: a prospective cohort study

Cited by 11 publications

References 41 publications

Healthy working life expectancy at age 50 for people with and without osteoarthritis in local and national English populations

Healthy working life expectancy at age 50 for people with and without osteoarthritis in local and national English populations

Sex differences in risk and heritability estimates on primary knee osteoarthritis leading to total knee arthroplasty: a nationwide population based follow up study in Danish twins

Comparing the Fiscal Consequences of Controlled and Uncontrolled Osteoarthritis Pain Applying a UK Public Economic Perspective

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