Anxiety and depression in knee osteoarthritic patients: Results from EMARTRO study

Milano, J. Vergés; Barbero, M. Herrero; Basallote, S. Giménez; Martin, JA; Lladó, E.; Serrano, H. Martínez; Roca, Genís; bellmunt, L. Sánchez; Muñoz, J. Díaz; Rodríguez, J. Frías; García, A. Castaño; Díaz, José Luis Cuadra; Cossío, Á. Rodríguez del; Prieto, Rita; Llisterri, JL

doi:10.1016/j.joca.2016.01.422

Cited by 7 publications

(8 citation statements)

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“…However, these symptoms had little or no association with performance-based and clinician-reported functional assessments, respectively. Therefore, this study supports that (1) the existence of depressive symptoms should be evaluated in routine assessments; especially, considering that PROM have been the gold standard for clinical verification in subjects with KOA, and that the rate of depressive symptoms is high (consistently, it was registered an approximate of 30% [ 7 , 8 ]); (2) functional measures based on both the perception of patients and assessors should be also used in practice. These findings contribute to a more complete picture of the functional status of patients with KOA, and how psychological status influences the patient’s self-perception of health.…”

Section: Discussionsupporting

confidence: 73%

“…Both clinical symptoms are influenced by a complex interaction between psychological, pathological, socio-demographic, and disability factors, commonly present in KOA [ 1 – 3 ]. Indeed, these patients frequently present with depressive symptoms associated with their condition [ 4 , 5 ], with an approximate prevalence of 20% [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Patient, clinician, and performance-based measures provide different information about clinical symptoms in patients with severe knee osteoarthritis presenting with depressive symptoms: a cross-sectional study

Pérez-Maletzki,

Domínguez-Navarro,

Roig-Casasús

et al. 2023

BMC Musculoskelet Disord

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Background and purpose Clinical status of subjects with knee osteoarthritis (KOA) is influenced by a complex interaction of several biopsychosocial factors. The use of patient-reported measures (PROM) is considered the gold standard for their evaluation. However, considering that 1 in 5 subjects with KOA present with depressive symptoms, it is necessary to analyse how this psychological domain may influence the subjective perception of PROM. The objective was to study the impact that depressive symptoms have on functional outcome assessments, according to the degree of objectivity of diverse outcome measures. Methods Cross-sectional study. Subjects with severe KOA, verified with clinical and radiological symptoms, were assessed with patient-reported (Oxford Knee Score), clinician-reported (knee range of motion), and performance-based (Timed up and go test) measures. The existence of depressive symptoms was assessed with the Yesavage scale, and participants were classified for having no-, mild- or severe-symptoms. Linear correlations (r) and one-way analysis of variance compared groups (95% CI). Results 244 participants were analysed, of which 75 (30.7%) had depressive symptoms. These symptoms had an inverse moderate association with Oxford Knee Score (r = -0.387). However, the correlation with the Timed up and go test was low (r = 0.176), while there was no correlation with knee ROM (r = -0.087). Conclusions This study supports that patient-reported questionnaires may offer biased information on the clinical status of patients with severe knee osteoarthritis who present with depressive symptoms. Consideration of such symptoms may be critical to ensure data collected to accurately reflect patients’ capacities and perceptions.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Patient, clinician, and performance-based measures provide different information about clinical symptoms in patients with severe knee osteoarthritis presenting with depressive symptoms: a cross-sectional study

Pérez-Maletzki,

Domínguez-Navarro,

Roig-Casasús

et al. 2023

BMC Musculoskelet Disord

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“…A trend towards use of gabapentinoids in people with OA has been observed by others; Appleyard and colleagues reported that the likelihood of UK patients with OA being prescribed gabapentinoids increased between 2000 and 2015, although the lack of relevant diagnostic codes made it difficult to ascertain the reason for some prescriptions 26. It is not clear whether antidepressants and anxiolytics agents were prescribed off label for the treatment of pain in the present study or for the management of anxiety or depression associated with OA, as a higher proportion of cases than controls had depression and anxiety at indexing, in line with other studies 27. Our data, indicating a high use of multiple lines of pharmacological therapy and joint replacement surgery, support earlier findings that medications alone might not lead to patient satisfaction with their symptom control17 and suggest a need for more effective pain management approaches in the OA setting.…”

Section: Discussionsupporting

confidence: 49%

Health economic impact of moderate-to-severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data

et al. 2023

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ObjectiveDespite the prevalence of osteoarthritis (OA) in England, few studies have examined the health economic impact of chronic pain associated with OA. The aim of this study was to compare outcomes in patients with moderate-to-severe chronic pain associated with OA and matched controls without known OA.DesignRetrospective, longitudinal, observational cohort study.SettingElectronic records extracted from the Clinical Practice Research Datalink GOLD primary care database linked to Hospital Episode Statistics (HES) data set.ParticipantsPatients (cases; n=5931) ≥18 years and with existing diagnosis of OA and moderate-to-severe pain associated with their OA, and controls matched on age, sex, comorbidity burden, general practitioner (GP) practice and availability of HES data.InterventionsNone.Primary and secondary outcome measuresTotal healthcare resource use (HCRU) and direct healthcare costs during 0–6, 0–12, 0–24 and 0–36 months of follow-up. Secondary outcomes measures included pharmacological management and time to total joint replacement.ResultsPatients with moderate-to-severe chronic pain associated with OA used significantly more healthcare services versus matched controls, reflected by higher HCRU and significantly higher direct costs. During the first 12 months’ follow-up, cases had significantly more GP consultations, outpatient attendances, emergency department visits and inpatient stays than matched controls (all p<0.0001). Total mean costs incurred by cases during 0–12 months’ follow-up were five times higher in cases versus controls (mean (SD): £4199 (£3966) vs £781 (£2073), respectively). Extensive cycling through pharmacological therapies was observed; among cases, 2040 (34.4%), 1340 (22.6%), 841 (14.2%), 459 (7.7%) and 706 (11.9%) received 1–5, 6–10, 11–15, 16–20 and >20 lines of therapy, respectively.ConclusionsThis wide-ranging, longitudinal, observational study of real-world primary and secondary care data demonstrates the impact of moderate-to-severe chronic pain associated with OA in patients compared with matched controls. Further studies are required to fully quantify the health economic burden of moderate-to-severe pain associated with OA.

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“…Altogether, OA is the most common cause of severe long-term pain and disability in older adults, causing loss of work productivity and significant healthcare- and social support costs. Given the personal burden, the illness may result in a negative effect on mental health and may seriously impact the quality of life of patients and their relatives [ [7] , [8] , [9] ].…”

Section: Introductionmentioning

confidence: 99%

Challenges and opportunities of pharmacological interventions for osteoarthritis: A review of current clinical trials and developments

Vrouwe

Burggraaf

Kloppenburg

et al. 2021

Osteoarthritis and Cartilage Open

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Anxiety and depression in knee osteoarthritic patients: Results from EMARTRO study

Cited by 7 publications

References 0 publications

Patient, clinician, and performance-based measures provide different information about clinical symptoms in patients with severe knee osteoarthritis presenting with depressive symptoms: a cross-sectional study

Patient, clinician, and performance-based measures provide different information about clinical symptoms in patients with severe knee osteoarthritis presenting with depressive symptoms: a cross-sectional study

Health economic impact of moderate-to-severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data

Challenges and opportunities of pharmacological interventions for osteoarthritis: A review of current clinical trials and developments

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