title: Pain, depressive symptoms and medication in German patients with rheumatoid arthritis-results from the linking patient-reported outcomes with claims data for health services research in rheumatology (PROCLAIR) study.
abstract: OBJECTIVE
  Pain and depressive symptoms are common in patients with rheumatoid arthritis (RA). Information on the prevalence and treatment of both conditions in German RA patients is scarce.
  
  
  METHODS
  Using data from a nationwide statutory health insurance fund (BARMER GEK), 6193 RA patients aged 18 to 79 years were provided with a questionnaire covering a variety of items such as demographics, medical condition and quality of life in 2015. Pain caused by the joint disorder (11-point scale) was classified as none existent/mild, moderate or severe. Depressive symptoms were determined using the World Health Organization's five-item Well-being Index and categorized as none existent, mild or moderate/severe. Another item covered additional use of over-the-counter drugs. Data were linked to dispensation records.
  
  
  RESULTS
  A total of 3140 RA patients were included. Median age was 66 years (79% female). About 70% of patients were classified as having moderate or severe pain. Depressive symptoms were found in 52% and were far more common among patients with higher pain levels. Analgesic treatment ranged from 45% to 76% (non-opioid analgesics) and from 6% to 33% (opioids) in patients with no/mild pain and those reporting severe pain, respectively. In patients reporting moderate or severe pain, substantially higher prevalences of opioid use were observed among those with depressive symptoms. Depending on depressive symptoms, antidepressant use ranged from 7% to 37%. Overall, over-the-counter drug use varied between 30% and 59%.
  
  
  CONCLUSIONS
  Pain and depressive symptoms are highly prevalent in German RA patients, often present together and influence each other's treatment. Copyright © 2017 John Wiley & Sons, Ltd.
authors.affiliation: Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
authors.forename: Kathrin
authors.identifier: http://orcid.org/0000-0002-3957-9721
authors.initials: K
authors.lastname: Jobski
authors.affiliation: Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
authors.forename: Andres
authors.initials: A
authors.lastname: Luque Ramos
authors.affiliation: Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.
authors.forename: Katinka
authors.initials: K
authors.lastname: Albrecht
authors.affiliation: Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Hoffmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000453:epidemiology; D003863:Depression / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D000071066:Patient Reported Outcome Measures; D011788:Quality of Life; D012219:Rheumatology; D055815:Young Adult
chemical_list: D000700:Analgesics; D000928:Antidepressive Agents
keywords: analgesics; antidepressants; depressive symptoms; over-the-counter drugs; pain; pharmacoepidemiology; rheumatoid arthritis