Health-related quality of life and costs in patients with osteoarthritis on waiting list for total knee replacement.
OBJECTIVE
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 euro (95%CI 167.08-233.40) and total mean direct non-medical costs were 1234.87 euro (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.
Núñez
M
M
Department of Rheumatology, Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain. mnunez@clinic.ub.es
Núñez
E
E
Segur
J M
JM
Maculé
F
F
Sanchez
A
A
Hernández
Maria V
MV
Vilalta
C
C
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000191:economics / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014850:Waiting Lists