The burden of musculoskeletal conditions

C Palazzo,J-F Ravaud,A Papelard,P Ravaud,S Poiraudeau

doi:10.1016/j.joca.2014.02.419

Abstract

Objective Despite the burden of rheumatic and musculoskeletal diseases (RMDs), these conditions probably deserve more attention from public health authorities in several countries including developed ones. We assessed their contribution to disability. Methods Data on disabilities associated with RMDs were extracted from the national 2008–2009 Disability-Health Survey of 29,931 subjects representative of the population in France. We used the core set of disability categories for RMDs of the World Health Organization's International Classification of Functioning, Disability and Health for analysis. Diagnosis and disabilities were self-reported. We assessed the risk of disability associated with RMDs using odds ratios (ORs) and the societal impact of RMDs using the average attributable fraction (AAF). Results Overall 27.7% (about 17.3 million people) (95% CI 26.9–28.4%) of the population reported having RMDs. The most prevalent RMDs were low back pain (12.5%, 12.1–13.1) and osteoarthritis (12.3%, 11.8–12.7). People reporting osteoarthritis were more disabled in walking (adjusted OR 1.9, 1.7–2.2) than those without. People reporting inflammatory arthritis were more limited in activities of daily living (from 1.4, 1.2–1.8 for walking to 2.1, 1.5–2.9 for moving around). From a societal perspective, osteoarthritis was the main contributor to activity limitations (AAF 22% for walking difficulties). Changing jobs was mainly attributed to neck pain (AAF 13%) and low back pain (11.5%). Conclusion RMDs are highly prevalent and significantly affect activity limitations and participation restrictions. More effort is needed to improve care and research in this field.

Highlights

Hip and knee osteoarthritis (OA) are increasingly common conditions which represent a growing public health problem internationally, given ageing populations and rising rates of obesity
Reduction in HRQoL was greatest for females (mean AQoL (95%CI) 0.46 (0.40–0.51) vs 0.82 (0.81–0.83); p < 0.001)
Over the past decade there has been a substantial increase in demand for joint replacement surgery for severe OA in many countries, and demand for other health services is likely to grow in the years ahead

Summary

Introduction

Hip and knee osteoarthritis (OA) are increasingly common conditions which represent a growing public health problem internationally, given ageing populations and rising rates of obesity. The main themes covered in each interview included the journey from the development of OA to more severe joint disease, willingness to undergo joint replacement surgery, and perceived enablers and barriers to accessing conservative and surgical treatment. A range of barriers relating to health professionals was identified, including difficulty obtaining specialist referrals and medical opinions regarding the appropriate timing of joint replacement surgery. People with hip or knee OA experience a range of barriers to receiving conservative and surgical care and these included financial, personal and health systemrelated challenges. Despite the burden of rheumatic and musculoskeletal diseases (RMDs), these conditions probably deserve more attention from public health authorities in several countries including developed ones Changing jobs was mainly attributed to neck pain (AAF 13%) and low back pain (11.5%)

Objectives

Findings

Conclusion