Patient characteristics, pain treatment patterns, and incidence of total joint replacement in a US population with osteoarthritis.
Background: Currently available medications for chronic osteoarthritis pain are only moderately effective, and their use is limited in many patients because of serious adverse effects and contraindications. The primary surgical option for osteoarthritis is total joint replacement (TJR). The objectiv...
| Publicado en: | BMC Musculoskeletal Disorders Vol. 23; no. 1; pp. 1 - 9 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BioMed Central
9/23/2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=159299190&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 159299190 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712474 1CI5 jtl: BMC Musculoskeletal Disorders issn: 14712474 maglogo: N pubinfo: dt: 9/23/2022 vid: 23 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 159299190 159299190 NLM36151530 159299190 10.1186/s12891-022-05823-7 NLM36151530 159299190 ppf: 1 ppct: 8 formats: tig: atl: Patient characteristics, pain treatment patterns, and incidence of total joint replacement in a US population with osteoarthritis. aug: au: Shinde, Mayura Rodriguez-Watson, Carla Zhang, Tancy C. Carrell, David S. Mendelsohn, Aaron B. Nam, Young Hee Carruth, Amanda Petronis, Kenneth R. McMahill-Walraven, Cheryl N. Jamal-Allial, Aziza Nair, Vinit Pawloski, Pamala A. Hickman, Anne Brown, Mark T. Francis, Jennie Hornbuckle, Ken Brown, Jeffrey S. Mo, Jingping affil: Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA sug: subj: Osteoarthritis Surgery Chronic Pain Epidemiology Chronic Pain Drug Therapy Arthroplasty, Replacement Adverse Effects Osteoarthritis Drug Therapy Osteoarthritis Epidemiology Retrospective Design Antiinflammatory Agents, Non-Steroidal Adrenal Cortex Hormones Adverse Effects Adult Prospective Studies Analgesics, Opioid Therapeutic Use Incidence Human Comparative Studies Multicenter Studies Evaluation Research Validation Studies Clinical Assessment Tools Adult: 19-44 years ab: Background: Currently available medications for chronic osteoarthritis pain are only moderately effective, and their use is limited in many patients because of serious adverse effects and contraindications. The primary surgical option for osteoarthritis is total joint replacement (TJR). The objectives of this study were to describe the treatment history of patients with osteoarthritis receiving prescription pain medications and/or intra-articular corticosteroid injections, and to estimate the incidence of TJR in these patients.Methods: This retrospective, multicenter, cohort study utilized health plan administrative claims data (January 1, 2013, through December 31, 2019) of adult patients with osteoarthritis in the Innovation in Medical Evidence Development and Surveillance Distributed Database, a subset of the US FDA Sentinel Distributed Database. Patients were analyzed in two cohorts: those with prevalent use of "any pain medication" (prescription non-steroidal anti-inflammatory drugs [NSAIDs], opioids, and/or intra-articular corticosteroid injections) using only the first qualifying dispensing (index date); and those with prevalent use of "each specific pain medication class" with all qualifying treatment episodes identified.Results: Among 1 992 670 prevalent users of "any pain medication", pain medications prescribed on the index date were NSAIDs (596 624 [29.9%] patients), opioids (1 161 806 [58.3%]), and intra-articular corticosteroids (323 459 [16.2%]). Further, 92 026 patients received multiple pain medications on the index date, including 71 632 (3.6%) receiving both NSAIDs and opioids. Altogether, 20.6% of patients used an NSAID at any time following an opioid index dispensing and 17.2% used an opioid following an NSAID index dispensing. The TJR incidence rates per 100 person-years (95% confidence interval [CI]) were 3.21 (95% CI: 3.20-3.23) in the "any pain medication" user cohort, and among those receiving "each specific pain medication class" were NSAIDs, 4.63 (95% CI: 4.58-4.67); opioids, 7.45 (95% CI: 7.40-7.49); and intra-articular corticosteroids, 8.05 (95% CI: 7.97-8.13).Conclusions: In patients treated with prescription medications for osteoarthritis pain, opioids were more commonly prescribed at index than NSAIDs and intra-articular corticosteroid injections. Of the pain medication classes examined, the incidence of TJR was highest in patients receiving intra-articular corticosteroids and lowest in patients receiving NSAIDs. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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