Quantifying healthcare resource utilisation for the management of moderate-to-severe chronic pain among patients with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data

Lohan, C.; Stevenson, Hannah; Coates, Gordon; Wood, Robert; Blackburn, S.; Tritton, Theo; Knaggs, Roger; Dickson, Alison; Walsh, David A.

doi:10.1016/j.joca.2021.02.498

Cited by 2 publications

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“…Due to the specific nature of our cohort definitions and the data held in the SIR, it is challenging to compare the incidence of HCRU with previously published studies. However, several studies support our findings of increasing HCRU with increasing OA pain severity in other populations [ 12 , 13 , 15 , 27 , 39 ]. A recent study using CPRD data from across the UK used almost identical inclusion criteria to ours for patients with moderate to severe OA pain and control cohorts [ 27 ].…”

Section: Discussionsupporting

confidence: 88%

“…However, several studies support our findings of increasing HCRU with increasing OA pain severity in other populations [ 12 , 13 , 15 , 27 , 39 ]. A recent study using CPRD data from across the UK used almost identical inclusion criteria to ours for patients with moderate to severe OA pain and control cohorts [ 27 ]. This analysis included 28% of patients from the North of the UK, which would include Salford.…”

Section: Discussionsupporting

confidence: 88%

“…Patients ≥ 18 years old with at least one moderate to severe or severe pain event within an episode of chronic pain (see definition below) were indexed from the SIR between 1 January 2010 and 31 December 2017 (Fig. 1 ) [ 27 ]. Patients must have had at least one prior diagnosis of OA in their recorded medical history, as defined by read or International Classification of Diseases 10th revision codes (see Table S1 in the electronic supplementary material for details).…”

Section: Methodsmentioning

confidence: 99%

“…These are likely to differ from those reported in the United States due to the nature of the regional healthcare systems and treatment pathways [ 2 ]. A recent analysis of linked data for primary (Clinical Practice Research Datalink [CPRD]) and secondary (Hospital Episode Statistics [HES]) care in England showed that patients with moderate to severe OA pain consistently used more healthcare services compared with control patients without OA [ 27 ]. This included significantly more general practitioner (GP) consultations, outpatient attendances, accident and emergency (A&E) visits, inpatient stays, and a significantly higher overall direct cost (+ £4778 per patient over 2 years) [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…A recent analysis of linked data for primary (Clinical Practice Research Datalink [CPRD]) and secondary (Hospital Episode Statistics [HES]) care in England showed that patients with moderate to severe OA pain consistently used more healthcare services compared with control patients without OA [ 27 ]. This included significantly more general practitioner (GP) consultations, outpatient attendances, accident and emergency (A&E) visits, inpatient stays, and a significantly higher overall direct cost (+ £4778 per patient over 2 years) [ 27 ]. Although linked CPRD-HES data are available for patients located across England, many health services are managed at a local level, and there are regional differences in the incidence and management of OA, possibly for socioeconomic reasons [ 28 – 30 ].…”

Section: Introductionmentioning

confidence: 99%

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An Observational Retrospective Matched Cohort Study of Healthcare Resource Utilisation and Costs in UK Patients with Moderate to Severe Osteoarthritis Pain

et al. 2022

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Introduction Using data from patients residing in Salford, UK, we aimed to compare healthcare resource utilisation (HCRU) and direct healthcare costs between patients with moderate to severe (M-S) or severe osteoarthritis (OA) pain and those without OA. Methods Patients with a M-S OA pain event within a period of chronic pain were indexed from the Salford Integrated Record (SIR) between 2010 and 2017. Patients with a severe pain event formed an OA subcohort. Patients in each OA pain cohort were independently matched to patients without OA, forming two control cohorts. HCRU, prescribed analgesic drugs, and total direct costs per UK standardised tariffs were calculated for the year post-index. Multivariable models were used to identify drivers of healthcare cost. Results The M-S OA pain and control cohorts each comprised 3123 patients; the severe OA pain and control cohorts each comprised 1922 patients. Patients in both OA pain cohorts had a significantly higher mean number of general practitioner encounters, inpatient, outpatient, and accident and emergency visits, and were prescribed a broader range of analgesic drugs in the year post-index than respective controls. Mean healthcare costs of all types were significantly higher in the M-S and severe OA pain cohorts vs controls (total: M-S £2519 vs £1379; severe £3389 vs £1397). Paracetamol (M-S: 40% of patients had at least one prescription; severe: 50%) and strong opioids (34% and 59%) were the analgesics most prescribed to patients with OA pain. In all cohorts, multivariable models showed that a higher age at index, the presence of gout, osteoporosis, type 2 diabetes, or coronary artery disease, significantly contributed towards higher healthcare costs. Conclusion In the population of Salford, UK, patients with M-S OA pain had significantly higher annual HCRU and costs compared with matched controls without OA; generally, these were even higher in patients with severe OA pain. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-022-00431-2.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An Observational Retrospective Matched Cohort Study of Healthcare Resource Utilisation and Costs in UK Patients with Moderate to Severe Osteoarthritis Pain

et al. 2022

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Estimating the cost and epidemiology of mild to severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data

Lohan,

Coates,

Clewes

et al. 2023

BMJ Open

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ObjectiveOsteoarthritis (OA) affects 10% of adults in the UK. Despite over one-third of people with OA experiencing chronic pain, few studies have examined the population-level impact of chronic pain associated with OA. We compared resource-use and epidemiological outcomes in patients with mild, moderate and severe chronic OA-associated pain and matched controls without known OA.DesignRetrospective, longitudinal, observational cohort study (July 2008 to June 2019).SettingElectronic records extracted from Clinical Practice Research Datalink GOLD primary care linked to Hospital Episode Statistics (HES).ParticipantsPatients (cases; n=23 016) aged ≥18 years with chronic OA-associated pain. Controls (n=23 016) without OA or chronic pain matched on age, sex, comorbidity burden, general practitioner practice and available HES data.InterventionsNone.Primary and secondary outcome measuresTotal healthcare resource use (HCRU), direct healthcare costs in 0–12, 12–24 and 24–36 months postindex. Secondary outcomes included incidence and prevalence of chronic OA-associated pain and pharmacological management.ResultsHCRU was consistently greater in cases versus controls for all resource categories during preindex and postindex periods. Across follow-up periods, resource use was greatest in patients with severe pain. In the first 12 months postindexing, mean total costs incurred by cases were four times higher versus matched controls (£256 vs £62); costs were approximately twice as high in cases vs controls for months 12–24 (£166 vs £86) and 24–36 (£150 vs £81; all p<0.0001). The incidence of new cases of chronic pain associated with OA was 2.64 per 1000 person-years; the prevalence was 1.4%.ConclusionsThis study highlights the real-world cost of chronic pain associated with OA in cases versus matched controls. We included patients with mild, moderate and severe pain associated with OA, and showed HCRU in discrete 1-year time frames. The true economic burden of pain associated with OA is likely to be considerably higher when indirect costs are considered.

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Quantifying healthcare resource utilisation for the management of moderate-to-severe chronic pain among patients with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data

Cited by 2 publications

References 0 publications

An Observational Retrospective Matched Cohort Study of Healthcare Resource Utilisation and Costs in UK Patients with Moderate to Severe Osteoarthritis Pain

An Observational Retrospective Matched Cohort Study of Healthcare Resource Utilisation and Costs in UK Patients with Moderate to Severe Osteoarthritis Pain

Estimating the cost and epidemiology of mild to severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data

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