title: Relationship between patient-reported disease severity in osteoarthritis and self-reported pain, function and work productivity.
abstract: BACKGROUND
  Understanding the relationship between patient-reported osteoarthritis (OA) severity and other patient-reported outcomes in the real-world clinical setting can provide a basis for appropriate patient management. The objective of this study was to determine how patient-reported OA severity correlates with patient-reported outcomes including pain, function and productivity.
  
  
  METHODS
  We used the Adelphi Disease Specific Programme (DSP) for OA, a database aggregated from large, multinational, observational studies for specific chronic diseases. Data were obtained based on a 0 to 100 mm pain visual analogue scale (VAS) and a series of questions including functioning (that is, activities of daily living) and work productivity. OA severity was rated by the patients based on the question "How bad would you say your arthritis is now?" with potential responses of "mild," "moderate," and "severe." Regression models and chi-square analyses were used to evaluate the relationships between self-reported OA severity and other outcomes.
  
  
  RESULTS
  Of 998 subjects in the OA DSP U.S. database, 714 (72.5%) agreed to participate. This sample was predominantly female (61.7%) with a mean age of 63.8 ± 12.9 years. Increased OA severity was associated with an older population (P < 0.05). With increasing OA severity (mild, moderate, severe), statistically significant differences (P < 0.05) were observed in increased pain VAS scores (23.5, 50.2, 70.8, respectively), lower functioning outcomes, and a higher percent of overall work impairment due to OA (17%, 37%, 48%, respectively). The increased work impairment at greater severity levels also resulted in higher costs related to lost work productivity, with annual costs due to lost productivity estimated at $6,096, $13,2510, and $17,214 per patient for self-reported mild, moderate, and severe OA, respectively (P < 0.05 for pairwise comparisons).
  
  
  CONCLUSIONS
  In the clinical practice setting, patient-reported OA severity was associated with other key patient-reported outcomes and thus may provide an accurate and tangible assessment of patients' perceptions of their disease. Identifying OA patients by their perceived severity level may be of benefit to patients and health-care providers when choosing treatment options aimed at reducing pain, and improving function and productivity.
authors.affiliation: Pfizer Inc, Global Health Economics and Outcomes Research, New York, NY 10017, USA. alesia.sadosky@pfizer.com
authors.forename: Alesia B
authors.initials: AB
authors.lastname: Sadosky
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Bushmakin
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Cappelleri
authors.forename: David R
authors.initials: DR
authors.lastname: Lionberger
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D016208:Databases, Factual; D004185:Disability Evaluation; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000191:economics / Q000453:epidemiology* / Q000503:physiopathology*; D010146:Pain / Q000191:economics / Q000453:epidemiology* / Q000503:physiopathology*; D012720:Severity of Illness Index; D055815:Young Adult