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Inadequate pain relief and large functional loss among patients with knee osteoarthritis: evidence from a prospective multinational longitudinal study of osteoarthritis real-world therapies

机译:膝关节骨关节炎患者的疼痛缓解不足和功能丧失较大:一项有关骨关节炎真实世界疗法的前瞻性跨国纵向研究的证据

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摘要

>Objective. To estimate the prevalence of inadequate pain relief (IPR) among patients with symptomatic knee OA prescribed analgesic therapy and to characterize patients with IPR.>Methods. Patients ≥50 years old with physician-diagnosed knee OA who had taken topical or oral pain medication for at least 14 days were recruited for this prospective non-interventional study in six European countries. Pain and function were assessed using the Brief Pain Inventory (BPI) and the WOMAC; quality of life (QoL) was assessed using the 12-item short form. IPR was defined as an average pain score of >4 out of 10 on BPI question 5.>Results. Of 1187 patients enrolled, 68% were female and the mean age was 68 years (s.d. 9); 639 (54%) met the definition of IPR. Patient responses for the BPI average pain question were well correlated with responses on the WOMAC pain subscale (Spearman r = 0.64, P < 0.001). In multivariate logistic regression, patients with IPR had greater odds of being female [adjusted odds ratio (adjOR) 1.90 (95% CI 1.46, 2.48)] and having OA in both knees [adjOR 1.48 (95% CI 1.15, 1.90)], higher BMI, longer OA duration, depression or diabetes. Patients with IPR (vs non-IPR) were more likely to have worse QoL, greater function loss and greater pain interference.>Conclusion. IPR is common among patients with knee OA requiring analgesics and is associated with large functional loss and impaired QoL. Patients at particular risk of IPR, as characterized in this study, may require greater attention towards their analgesic treatment options.>Trial registration: ().
机译:>目的。评估有症状膝关节OA处方镇痛治疗的患者中疼痛缓解不足(IPR)的患病率,并对IPR患者进行特征描述。>方法。≥50岁的患者这项在六个欧洲国家进行的前瞻性非干预性研究招募了经医生诊断的膝盖OA且至少接受了14天内局部或口服止痛药治疗的患者。使用简短疼痛量表(BPI)和WOMAC评估疼痛和功能。使用12个项目的简短形式评估生活质量(QoL)。 IPR的定义是BPI问题5的平均疼痛评分> 10分中的4分。>结果。在1187名患者中,女性占68%,平均年龄为68岁(s.d. 9)。 639个(54%)符合IPR的定义。 BPI平均疼痛问题的患者反应与WOMAC疼痛分量表的反应密切相关(Spearman r = 0.64,P <0.001)。在多因素logistic回归分析中,IPR患者的女性几率更高[调整后的优势比(adjOR)1.90(95%CI 1.46,2.48)],双膝OA [adjOR 1.48(95%CI 1.15,1.90)],较高的BMI,较长的OA时间,抑郁症或糖尿病。 IPR(而非IPR)患者的QoL较差,功能丧失和疼痛干扰更大。>结论。IPR在需要镇痛药的膝OA患者中很常见,并且与功能大有关损失和生活质量受损。如本研究所述,处于IPR特殊风险的患者可能需要更多地关注其止痛药的选择。>试验注册:()。

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