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Neuropathic-like symptoms and the association with joint-specific function and quality of life in patients with hip and knee osteoarthritis.

ABSTRACT: OBJECTIVE:There is an association between osteoarthritis-related pain severity and function, yet clear evidence about the sole influence of neuropathic-like symptoms on joint function and health-related quality of life (HRQoL) is lacking. Previous studies among knee OA patients show an association between neuropathic-like symptoms, lower functional status and lower quality of life, however analyses were unadjusted or had limited adjustment for influential covariates like pain intensity. The aim of this study was therefore to determine the influence of neuropathic-like symptoms-adjusted for multiple influential covariates-on joint-specific function and HRQoL in hip and knee OA patients. METHODS:In this observational study 255 patients (117 with hip OA and 138 with knee OA) completed the modified painDETECT questionnaire (mPDQ) to identify subjects with neuropathic-like symptoms (mPDQ score>12, possible neuropathic pain [NP] phenotype). The WOMAC and the RAND-36 were used to asses respectively function and HRQoL. Results were adjusted stepwise for age, sex and BMI (Model 1); back disorder, painful body regions, comorbidities and previous surgery (Model 2); and pain intensity and analgesic usage (Model 3). RESULTS:A possible NP phenotype was experienced by 37% of hip and 46% of knee OA patients. Final model 3 analysis revealed that hip OA patients with neuropathic-like symptoms scored significantly lower on pain-related aspects of HRQoL (?RAND-36 bodily pain: 6.8 points, p = 0.047) compared to patients with the unlikely NP phenotype. In knee OA patients, a possible NP phenotype was associated with diminished joint function (?WOMAC domains ranging 7.1 to 10.5 points, p<0.05) and more deficits on the physical functional aspect of HRQoL (?RAND-36 physical functioning: 6.8 points, p = 0.016). CONCLUSION:Neuropathic-like symptoms deteriorate the subjective rating of pain-related quality of life in hip OA patients and significantly influence function in knee OA patients.

SUBMITTER: Blikman T

PROVIDER: S-EPMC6002060 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Neuropathic-like symptoms and the association with joint-specific function and quality of life in patients with hip and knee osteoarthritis.

Blikman Tim T Rienstra Wietske W van Raay Jos J A M JJAM Dijkstra Baukje B Bulstra Sjoerd K SK Stevens Martin M van den Akker-Scheek Inge I

PloS one 20180614 6

<h4>Objective</h4>There is an association between osteoarthritis-related pain severity and function, yet clear evidence about the sole influence of neuropathic-like symptoms on joint function and health-related quality of life (HRQoL) is lacking. Previous studies among knee OA patients show an association between neuropathic-like symptoms, lower functional status and lower quality of life, however analyses were unadjusted or had limited adjustment for influential covariates like pain intensity. ...[more]

PMID: 29902245

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Project description:BackgroundThe purpose was to determine the professionally-guided and self-guided medication and supplement use for joint symptom management among patients with knee and/or hip osteoarthritis (OA) in an urban hospital-based outpatient orthopedic practice.MethodsThe study design was cross-sectional. Patients diagnosed by radiographs and clinical symptoms with knee and/or hip OA were recruited from an inner-city hospital-based outpatient orthopaedic office. A total of 184 patients were queried for their participation. Four investigator-generated, interview-based questionnaires were used. Sampling error was ±7.84%. Logistic regression models and Fisher Exact Tests were performed to determine factors that may be associated with negative behaviors related to medication or supplement use (e.g., reporting medication as ineffective, using multiple medications in the same day to manage symptoms). Odds ratios (OR) and 95% confidence intervals (CI) were calculated for significant findings.ResultsAmong the 162 participants, a majority reported professionally-guided recommendations and over 40% reported at least one self-guided intervention. 37 participants reported dual-use during the same day, and among those,15 reported dual-use at the same time. Among participants taking multiple interventions in the same day, 40.5% reported using prescription and over-the-counter medications. Use of multiple medications or supplements in one day was more common among participants who reported OA at multiple joints (OR [95% CI]=2.48 [1.03 to 5.96]) but less common among participants who did not complete high school (OR [95% CI]=0.26 [0.08 to 0.83]). Of the 15 participants who reported dual-use at the same time, 11 were professionally-guided, 5 were professional and self-guided, and 1 was solely self-guided. Overall, 28% of participants reported their intervention as ineffective, sought an alternative method to achieve symptomatic relief, or were prescribed a stronger medication. Participants who reported not always taking their medication consistently for 2 weeks were more likely to report their medication as ineffective (OR [95% CI]=2.87 [1.19 to 6.92]).ConclusionsBoth professional and self-guided medications and supplements are used by inner city OA patients to manage their joint symptoms. It is important for clinicians to discuss with these patients how to effectively manage multiple joint symptoms, the importance of taking medications as prescribed, and what they should if they believe a treatment is ineffective or their medication runs out.

Dataset Information

Neuropathic-like symptoms and the association with joint-specific function and quality of life in patients with hip and knee osteoarthritis.

Publications

Neuropathic-like symptoms and the association with joint-specific function and quality of life in patients with hip and knee osteoarthritis.

Similar Datasets

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