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Pain, disability and health-related quality of life in osteoarthritis—joint matters: an observational, multi-specialty trans-national follow-up study

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Abstract

The authors aimed to test potential relations between osteoarthritis (OA) features, disability and health-related quality of life (HR-QoL) at different body locations. Outpatients consulting for pain associated to self-reported OA at varied healthcare settings were evaluated in a 3-month observational non-controlled follow-up study. Socio-demographic/anthropometric and medical data were collected at three time points. Lequesne’s indices, quick-disabilities of arm, shoulder and hand (DASH) and Oswestry questionnaires provided measures of physical function and disability. HR-QoL measures were obtained with EuroQol-5 Dimensions. Multivariate analyses were used to evaluate the differences of pain severity across body regions and the correlates of disability and HR-QoL. Six thousand patients were evaluated. Pain lasted 2 years or more in 3995 patients. The mean pain severity at baseline was moderate (6.4 points). On average, patients had pain in 1.9 joints/areas. The pain was more severe when OA involved the spine or all body regions. Pain severity explained much of the variance in disability and HR-QoL; this association was less relevant in patients with OA in the upper limbs. There were considerable improvements at follow up. Pain severity improved as did disability, which showed particularly strong associations with HR-QoL improvements. Pain severity is associated with functional limitations, disability and poor HR-QoL in patients with self-reported OA. Functional limitations might have particular relevance when OA affects the upper limbs. Improvements are feasible in many patients who consult because of their pain.

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Acknowledgements

Authors are grateful for the interest and time of clinical investigators and patients who voluntarily contributed their data for this research. The authors also wish to acknowledge STAR study investigators: A Coruña (Dr. Alhendi, Dra. Antelo, Dr. Blanco, Dr. Carceller, Dra. de la Iglesia, Dr. Díaz, Dr. García, Dr. Freire, Dr. Pérez, Dra. Rivas, Dr. Sines); Álava (Dra. Ayala, Dra. Cabello, Dra. Fernández); Albacete (Dr. Arcas, Dr. Carteleanu, Dr. García, Dr. Hernández, Dr. Jiménez, Dr. Júdez); Alicante (Dr. Escuder, Dr. González, Dr. Juan, Dr. Llanos, Dr. Moreno, Dr. Parrondo, Dr. Pérez, Dr. Tafalla, Dr. Torres, Dr. Tovar); Asturias (Dr. Acebal); Ávila (Dra. Contreras, Dr. Gil, Dr. Pinto); Badajoz (Dr. Domínguez, Dr. Lozano, Dr. Llera, Dr. Soler); Barcelona (Dra. Acosta, Dr. Amat, Dr. Ballart, Dr. Barberán, Dra. Barcelo, Dr. Benalcazar, Dra. Calahorrano, Dr. Casals, Dr. de Córdoba, Dr. de Sanctis, Dr. Echevarría, Dr. Fabo, Dr. Fernández, Dra. Ferreras, Dr. Folch, Dr. F González, Dr. J González, Dr. Guevara, Dra. Landaluze, Dr. Lopez, Dra. Magallares, Dr. Malouff, Dra. Martí, Dra. Martínez, Dr. Mayoral, Dr. Moreno, Dra. Nadal, Dr. Payan, Dr. Pellejero, Dra. Ribera, Dra. Roca, Dr. Romero, Dr. Samper, Dr. Serrano, Dra. Sintes, Dr. Sole, Dr. Solsona, Dr. Suarez, Dr. Vázquez, Dr. Vélez, Dra. Vidal); Cáceres (Dr. Leal, Dr. Abello); Cádiz (Dr. Alvarado, Dra. Álvarez, Dr. Armario, Dr. Aragón, Dr. Benítez, Dr. Calderón, Dra. del Pino, Dr. F García, Dr. S García, Dr. Gómez, Dr. F Martínez, Dr. J Martínez, Dr. MA Martínez, Dr. Menor, Dr. Morales, Dra. Moreno, Dr. Ramírez, Dr. Revenga, Dr. Sánchez de las Matas, Dra. Solís, Dr. Ventura); Cantabria (Dr. Agudo, Dra. Expósito, Dra. Martínez, Dra. Ortega, Dr. Rueda, Dra. Santillán, Dr. Sarabia); Castellón (Dra. Gil, Dr. Gómez, Dr. Mercado, Dr. Palomar, Dr. Tirado, Dr. Vicent, Dr. Vila); Ceuta (Dr. El Hmindi); Ciudad Real (Dra. Acal, Dr. Ariza, Dr. Jiménez, Dra. Monge, Dr. Molina, Dr. Paulino); Córdoba (Dra. Arroyo, Dr. Bretones, Dr. Carmona, Dr. Gómez, Dr. Jiménez, Dr. Quevedo, Dr. Vega); Girona (Dr. Beltrán, Dra. Charry, Dr. Galán, Dra. Mariñansky, Dr. Matamoros, Dr. Medina, Dr. Morales, Dr. Paredes, Dra. Ruiz); Granada (Dr. Almazán, Dr. Eugenio, Dr. Morales, Dr. Muñoz, Dra. Pozuelo, Dr. Velázquez, Dr. Villazán); Guadalajara (Dr. Pérez); Guipúzcoa (Dr. Etxebarría, Dra. Madariaga); Huelva (Dra. Llanes, Dr. Pérez); Huesca (Dr. Alarcón, Dra. Casas, Dr. Carrión, Dr. Manuel, Dr. Narro, Dr. Labad, Dr. Pina, Dr. Sánchez); Islas Baleares (Dr. Llabrés, Dr. Mirasol, Dr. Moya, Dra. Peláez, Dr. Salazar, Dr. Verd); Jaén (Dr. Esqueta, Dr. García, Dra. Gil, Dra. Granados, Dr. Martínez, Dr. Martos, Dr. Moreno); La Rioja (Dr. Malillos); Las Palmas (Dr. García, Dra. Martín, Dra. Medina, Dr. Sánchez); León (Dr. Bronte, Dr. Gutiérrez, Dra. Medina); Lleida (Dr. Charlez, Dra. Martínez, Dra. Matute, Dr. Puertas); Lugo (Dra. Albores, Dr. Miguéns); Madrid (Dra. Acedo, Dr. Alonso, Dra. Alonso, Dra. Aranda, Dra. Arconada, Dr. Bachiller, Dra. Balmisa, Dra. Bedmar, Dr. de la Gala, Dra. de Miguel, Dra. Díaz, Dr. Elices, Dr. Esparragoza, Dr. Estrada, Dra. MC Fernández, Dra. R Fernández, Dr. Gago, Dr. JA García, Dr. MA García, Dra. González, Dra. Infante, Dr. Leal, Dra. Llaurado, Dra. López, Dr. Miranda, Dr. Moreno, Dr. Molero, Dra. Nieto, Dra. Ortiz, Dra. Palomino, Dra. Peralta, Dr. Ruiz, Dra. Sánchez, Dra. Sanz, Dra. Spottorno, Dra. Vaquerizo); Málaga (Dr. Aldaya, Dra. Belmonte, Dr. Cara, Dra. Coret, Dr. González, Dr. de Linares, Dra. del Valle, Dr. Esteban, Dr. A Fernández, Dr. JA Fernández, Dr. M Fernández, Dr. García, Dra. Panero, Dr. Ponce, Dr. Rosón, Dr. Sánchez); Murcia (Dr. Aguilar, Dra. Agulló, Dra. Cirera, Dr. García, Dr. García-Giralda, Dr. Giménez, Dr. Gómez, Dr. Leal, Dr. Marras, Dra. Oliva, Dr. Ortega); Navarra (Dr. Ceberio, Dr. Gutiérrez, Dr. Sainz de Murieta); Ourense (Dra. Cánovas, Dr. Fernández, Dr. Fórmigo); Palencia (Dr. Álvarez, Dra. Páez); Pontevedra (Dra. Balsa, Dra. Mayo, Dra. Pampín, Dra. Romo); Salamanca (Dr. García, Dr. Moreno, Dr. Santos); Santa Cruz de Tenerife (Dr. Calvo, Dr. Cornejo, Dr. de la Paz, Dr. de Santiago, Dr. Maffiotte, Dra. Mencías, Dr. Muñoz, Dr. Ojeda, Dr. Santos, Dr. Vargas); Sevilla (Dr. Ballesteros, Dr. Baturone, Dr. Bordás, Dra. Bravo, Dra. León, Dra. Llanes, Dr. Méndez, Dr. Periáñez, Dr. Román, Dr. Rubio); Tarragona (Dra. Bella, Dra. Ferre, Dr. Fos, Dr. Fuentes, Dra. Gómez, Dra. Padrol, Dra. Roca); Teruel (Dra. Escartín, Dr. Giner), Toledo (Dr. Cabañas, Dr. Parrón); Valencia (Dr. Alcañiz, Dr. Alegre, Dr. Alfonso, Dr. Arriete, Dr. Asensio, Dr. Baeza, Dra. Bonond, Dra. Cabanes, Dra. Candel, Dra. Canos, Dra. Chumillas, Dr. Colomer, Dra. Domínguez, Dr. Fabregat, Dr. Fenollosa, Dr. Garijo, Dr. Gómez, Dr. Gomis, Dr. Gorgues, Dra. Izquierdo, Dr. Martín, Dra. Martín, Dr. Moreno, Dra. Navarro, Dr. Osca, Dr. Sánchez, Dr. Santamaría, Dra. Serrano, Dra. Tejero, Dr. Vidal, Dr. Villanueva, Dr. Villazala); Valladolid (Dra. Cebrián, Dr. R García, Dr. S García, Dr. González, Dr. Hernández, Dr. León, Dr. Sierra, Dr. Vaca); Vizcaya (Dr. Álava, Dra. Callejo, Dra. Fernández, Dr. García, Dra. Gómez, Dra. Latorre, Dra. López, Dra. Mozas, Dra. Muñoz, Dr. Ortíz, Dra. Ortiz, Dr. Reoyo, Dr. Saez, Dra. Torralba, Dr. Torre, Dra. Urtusagasti, Dr. Zugazabeitia); Zaragoza (Dra. Acín, Dr. Beltrán, Dr. Domingo, Dra. Lamban, Dr. Navarro, Dr. Panisello, Dr. Pons, Dra. Seral, Dra. Soriano). The authors also wish to thank Susana Traseira (Mundipharma) and Jesús Villoria (Medicxact) for their contribution during study design, data analysis and medical writing; Alfonso Casado, Ana Tabuenca for their assistance during statistical analysis.

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This research has been funded by Mundipharma, S.L. Mundipharma; S.L. did not have any direct corporate role in the design, analysis, and interpretation of results and preparation of the manuscript.

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Correspondence to Antonio Montero.

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AM, J-FM, CT and JG declare no competing interests to declare. MS has a full-time job at Mundipharma Pharmaceuticals, S.L.

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The accredited ethics committee of the University Hospital Arnau de Vilanova in Lleida reviewed and approved the study protocol. All patients provided their written informed consent to participate and the use of their personal data for the purposes of the study. The study complied with the ethical standards of the updated Declaration of Helsinki.

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Montero, A., Mulero, JF., Tornero, C. et al. Pain, disability and health-related quality of life in osteoarthritis—joint matters: an observational, multi-specialty trans-national follow-up study. Clin Rheumatol 35, 2293–2305 (2016). https://doi.org/10.1007/s10067-016-3248-3

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