title: Prevalence and predictors of health care use in patients with early hip or knee osteoarthritis: two-year follow-up data from the CHECK cohort.
abstract: OBJECTIVE
  To describe health care utilization (HCU) and predict analgesic use and health professional (HP) contact at baseline and 2 years in individuals with early symptomatic hip and/or knee osteoarthritis (OA).
  
  
  METHODS
  Baseline and two-year data on HCU of the 1002 participants from the multi-centre Cohort Hip & Cohort Knee study were used. Six forms of health care services were described: analgesic use, supplement use, contact with a General Practitioner (GP), contact with a HP, contact in secondary care, and alternative medicine use. Multivariable logistic regression was performed in order to identify predisposing, enabling and disease-related variables that predict analgesic use and HP contact at 2 years; treatment modalities of first choice in early OA.
  
  
  RESULTS
  For the hip (n=170), the knee (n=414) and the hip and knee (n=418) group analgesic use (38%, 29% and 47%, respectively), contact with a GP (32%, 38% and 36%, respectively) and contact with a HP (26%, 18% and 20%, respectively), were reported most often at baseline. Contact with a GP significantly decreased, supplement use increased (to about one third), and other treatment modalities remained stable at 2 years. In all three groups, analgesic use at baseline was the strongest predictor for analgesic use at 2 years, whereas contact with a HP at baseline was the strongest predictor of contact with a HP after 2 years. Belonging to a first generation minority was a predisposing risk factor [Odds Ratio (95%-CI), 8.72 (1.55-48.97)] for analgesic use in the hip and knee group.
  
  
  CONCLUSIONS
  In early OA, familiarity with HCU and other predisposing factors are, apart from disease-related factors strongly associated with HCU at 2 years. Further research is necessary to examine whether our findings reflect sub-optimal management of early OA in terms of efficacy and equity.
authors.affiliation: Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. t.hoogeboom@maartenskliniek.nl
authors.forename: T J
authors.initials: TJ
authors.lastname: Hoogeboom
authors.forename: G F
authors.initials: GF
authors.lastname: Snijders
authors.forename: H A
authors.initials: HA
authors.lastname: Cats
authors.forename: R A
authors.initials: RA
authors.lastname: de Bie
authors.forename: S M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: F H J
authors.initials: FH
authors.lastname: van den Hoogen
authors.forename: P L C M
authors.initials: PL
authors.lastname: van Riel
authors.forename: P J
authors.initials: PJ
authors.lastname: Emans
authors.forename: J
authors.initials: J
authors.lastname: Wesseling
authors.forename: A A
authors.initials: AA
authors.lastname: den Broeder
authors.forename: C H M
authors.initials: CH
authors.lastname: van den Ende
mesh_terms: D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D000529:Complementary Therapies / Q000706:statistics & numerical data; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D019587:Dietary Supplements / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D004522:Educational Status; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015207:Osteoarthritis, Hip / Q000453:epidemiology / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D011369:Professional-Patient Relations
chemical_list: D000700:Analgesics