Noga Fallach1, Gabriel Chodick2,3, Matanya Tirosh4, Elon Eisenberg5,6, Omri Lubovsky7. 1. Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel. fallach_n@mac.org.il. 2. Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv, Israel. 3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Medical Affairs Pfizer Israel, Herzliya, Israel. 5. Rambam Health Care Campus, Haifa, Israel. 6. Rappaport Faculty of Medicine , Technion-Israel Institute of Technology, Haifa, Israel. 7. Barzilai Medical Center Ashkelon Israel, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Abstract
INTRODUCTION: There is limited evidence on the consumption of analgesics in real-world large cohorts of patients with osteoarthritis (OA), especially in those with comorbidities. We aimed to characterize the use of pharmacological analgesic treatments, evaluate standardized comorbidity rates, and assess treatment trends. Our hypotheses were: (1) OA patients generally consume low and inconsistent pharmacological analgesic treatments; (2) analgesic treatment is often non-congruent with comorbidity-related safety concerns. METHODS: The study was carried out at the second largest health maintenance organization in Israel. Members aged 18 years or above who were diagnosed with OA before December 31, 2018, were included. Information was obtained from the members' electronic medical record (EMR) including data on dispensed prescriptions, which were used to estimate analgesic consumption. RESULTS: A total of 180,126 OA patients were included in our analyses; analgesics were dispensed to 64.2% of the patients, with oral NSAIDs and opioids dispensed to 34.1 and 22.9% of the OA population, respectively. Analgesic use increased with time lapsed from OA diagnosis (p < 0.001), up to a median of 59 days covered (IQR, 20-175) after 21 years. Rates of most comorbidities in the OA population were higher compared to the MHS general population. Patients with comorbidities used more NSAIDs and opioids compared to those without them. CONCLUSIONS: Most OA patients use analgesics, usually oral NSAIDs. Analgesic use remains relatively low throughout the years, indicating that many OA patients are not being treated pharmacologically for pain on a regular basis. Despite having higher rates of several comorbidities compared to MHS general population, many OA patients are still treated with analgesics that can be associated with a worsening in comorbidity.
INTRODUCTION: There is limited evidence on the consumption of analgesics in real-world large cohorts of patients with osteoarthritis (OA), especially in those with comorbidities. We aimed to characterize the use of pharmacological analgesic treatments, evaluate standardized comorbidity rates, and assess treatment trends. Our hypotheses were: (1) OA patients generally consume low and inconsistent pharmacological analgesic treatments; (2) analgesic treatment is often non-congruent with comorbidity-related safety concerns. METHODS: The study was carried out at the second largest health maintenance organization in Israel. Members aged 18 years or above who were diagnosed with OA before December 31, 2018, were included. Information was obtained from the members' electronic medical record (EMR) including data on dispensed prescriptions, which were used to estimate analgesic consumption. RESULTS: A total of 180,126 OA patients were included in our analyses; analgesics were dispensed to 64.2% of the patients, with oral NSAIDs and opioids dispensed to 34.1 and 22.9% of the OA population, respectively. Analgesic use increased with time lapsed from OA diagnosis (p < 0.001), up to a median of 59 days covered (IQR, 20-175) after 21 years. Rates of most comorbidities in the OA population were higher compared to the MHS general population. Patients with comorbidities used more NSAIDs and opioids compared to those without them. CONCLUSIONS: Most OA patients use analgesics, usually oral NSAIDs. Analgesic use remains relatively low throughout the years, indicating that many OA patients are not being treated pharmacologically for pain on a regular basis. Despite having higher rates of several comorbidities compared to MHS general population, many OA patients are still treated with analgesics that can be associated with a worsening in comorbidity.
Authors: R C Lawrence; C G Helmick; F C Arnett; R A Deyo; D T Felson; E H Giannini; S P Heyse; R Hirsch; M C Hochberg; G G Hunder; M H Liang; S R Pillemer; V D Steen; F Wolfe Journal: Arthritis Rheum Date: 1998-05
Authors: Sharon L Kolasinski; Tuhina Neogi; Marc C Hochberg; Carol Oatis; Gordon Guyatt; Joel Block; Leigh Callahan; Cindy Copenhaver; Carole Dodge; David Felson; Kathleen Gellar; William F Harvey; Gillian Hawker; Edward Herzig; C Kent Kwoh; Amanda E Nelson; Jonathan Samuels; Carla Scanzello; Daniel White; Barton Wise; Roy D Altman; Dana DiRenzo; Joann Fontanarosa; Gina Giradi; Mariko Ishimori; Devyani Misra; Amit Aakash Shah; Anna K Shmagel; Louise M Thoma; Marat Turgunbaev; Amy S Turner; James Reston Journal: Arthritis Rheumatol Date: 2020-01-06 Impact factor: 10.995