Prevalence and predictors of health care use in patients with early hip or knee osteoarthritis: two-year follow-up data from the CHECK cohort

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• 作者：T.J. Hoogeboom^&dagger ; ; ^&Dagger ; ; ^{t.hoogeboom@maartenskliniek.nl} ; G.F. Snijders^&dagger ; ; H.A. Cats^&dagger ; ; R.A. de Bie^&Dagger ; ; S.M.A. Bierma-Zeinstra^§ ; ; F.H.J. van den Hoogen^&dagger ; ; P.L.C.M. van Riel^鈭?/sup> ; P.J. Emans^¶ ; ; J. Wesseling^# ; A.A. den Broeder^&dagger ; ; C.H.M. van den Ende^&dagger ;
• 关键词：Osteoarthritis ; Health services ; Analgesics ; Therapy ; Cohort studies
• 刊名：Osteoarthritis and Cartilage
• 出版年：2012
• 期刊代码：249_10634584
• 类别：med
• 出版时间：June, 2012
• 卷：20
• 期：6
• 页码：525-531
• 文件大小：148 K

摘要

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Summary

Objective

To describe health care utilization (HCU) and predict analgesic use and health professional (HP) contact at baseline and 2 years in individuals with early symptomatic hip and/or knee osteoarthritis (OA).

Design

Baseline and two-year data on HCU of the 1002 participants from the multi-centre Cohort Hip & Cohort Knee study were used. Six forms of health care services were described: analgesic use, supplement use, contact with a General Practitioner (GP), contact with a HP, contact in secondary care, and alternative medicine use. Multivariable logistic regression was performed in order to identify predisposing, enabling and disease-related variables that predict analgesic use and HP contact at 2 years; treatment modalities of first choice in early OA.

Results

For the hip (n = 170), the knee (n = 414) and the hip and knee (n = 418) group analgesic use (38%, 29%and 47%, respectively), contact with a GP (32%, 38%and 36%, respectively) and contact with a HP (26%, 18%and 20%, respectively), were reported most often at baseline. Contact with a GP significantly decreased, supplement use increased (to about one third), and other treatment modalities remained stable at 2 years. In all three groups, analgesic use at baseline was the strongest predictor for analgesic use at 2 years, whereas contact with a HP at baseline was the strongest predictor of contact with a HP after 2 years. Belonging to a first generation minority was a predisposing risk factor [Odds Ratio (95%-CI), 8.72 (1.55-48.97)] for analgesic use in the hip and knee group.

Conclusions

In early OA, familiarity with HCU and other predisposing factors are, apart from disease-related factors strongly associated with HCU at 2 years. Further research is necessary to examine whether our findings reflect sub-optimal management of early OA in terms of efficacy and equity.