PMS29 Quality of Life in Patients with Osteoarthritis from Sweden; A Cohort Analysis from the Biscuits Study

Abstract

Describe health-related quality of life (HRQoL) in patients with osteoarthritis (OA) from Sweden, including subgroups who may be disproportionately affected. As part of the BISCUITS study, patients were identified from 2011–2017 in the Swedish National Quality Register for Better management of patients with OA (NQR BOA), which includes patients seeking healthcare due to OA-related pain. Patients with cancer (C00–C43/C45–C97) were excluded. Five-level EQ-5D utility score and self-reported pain (visual analog scale) at index were extracted for the overall population and 12 subgroups with medical histories/treatment characteristics suggestive of poor HRQoL. Data for 85,134 patients were extracted (mean age 67 years; subgroups n=1,303–50,787). Most patients (59.7%) reported the knee to be the most painful joint. Mean EQ-5D score was 0.61 (SD: 0.23) with most patients reporting ‘lasting pain’ (82.7%) vs. ‘recurrent pain’ (16.8%), and a mean pain intensity score of 5.45/10 (SD: 2.05). Almost all subgroups had a lower mean EQ-5D than the overall population, with the top 10% of healthcare resource users in the year post-index (n=1896) and patients with persistent opioid use (≥4500mg oral morphine equivalents [OMEQ] in the year pre-index; n=2529) reporting the lowest scores (0.45 [SD: 0.28]; 0.41 [SD: 0.29]). Lasting pain was reported by >90% of top healthcare users, those receiving three sequential pain medication classes pre-index to year post-index (n=20,350), persistent (≥4500mg [n=2529], ≥8100mg OMEQ [n=1400], or 180 defined daily doses in year pre-index [n=1303]) and non-persistent opioid users (all not defined as persistent; n=14,607). These groups also reported higher mean pain intensities than the overall population. Difficulty walking was reported in 19.6% of all patients, with a notably higher proportion among those only attending primary care (26.5%; n=12,779). Patients with OA in Sweden experienced substantial HRQoL burden with multiple groups being disproportionately affected. This suggests current treatment options are suboptimal.