Is Longer Waiting Time for Total Knee Replacement Associated with Health Outcomes and Medication Costs? Randomized Clinical Trial

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• 作者：Ulla Tuominen ; PhD^a ; ^b ; ^{ulla.tuominen@thl.fi} ; Harri Sintonen ; PhD^b ; Johanna Hirvonen ; PhD^c ; Seppo Seitsalo ; MD ; PhD^d ; Pekka Paavolainen ; MD ; PhD^d ; Matti Lehto ; MD ; PhD^e ; Kalevi Hietaniemi ; MD^f ; Marja Blom ; PhD^g
• 关键词：cost ; health-related quality of life ; osteoarthritis ; randomized clinical trial ; waiting lists
• 刊名：Value in Health
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：13
• 期：8
• 页码：998-1004
• 全文大小：99 K

文摘

Background

The aim of this prospective randomized study was to evaluate the effect of waiting time (WT) on health-related quality of life (HRQoL), knee pain and physical function, and the use and costs of medication of patients awaiting total knee replacement.

Methods

When placed on the waiting list, 438 patients were randomized into a short waiting time (SWT ?3 months) or a nonfixed waiting time (NFWT > 3 months) group. HRQoL was measured by the 15D, and pain and physical function by modified Knee Society Clinical Rating System at baseline, admission, and 3 and 12 months postoperatively. The costs of medication due to osteoarthritis were calculated at the same measurement points. All analyses were performed using the intention-to-treat principle.

Results

The mean WT was 94 and 239 days in the SWT and NFWT groups, respectively. Apart from higher weekly cost of medication in the SWT group at admission and better HRQoL in the NFWT group 1 year postoperatively, there were no statistically significant differences between the groups in other outcomes during the follow-up.

Conclusion

Those in the SWT group had higher weekly costs of medication at admission, and reached better HRQoL 3 months earlier than those in the NFWT group, but the latter had better HRQoL after operation. Otherwise, the length of WT was not associated with different health and HRQoL outcomes in the groups.