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Burden of disease due to hip, knee, and unspecified osteoarthritis in the Peruvian social health insurance system (EsSalud), 2016.

ABSTRACT: Introduction: Since its introduction by the World Health Organization (WHO), the concept of burden of disease has been evolving. The current method uses life expectancy projected to 2050 and does not consider age-weighting and time-discounting. Our aim is to estimate the burden of disease due to hip, knee, and unspecified osteoarthritis using this new method in the Peruvian Social Health Insurance System (EsSalud) during 2016. Methods: We followed the original 1994 WHO study and the current 2015 Global Burden of Disease (GBD) methods to estimate disability adjusted life years (DALY) due to osteoarthritis, categorized by sex, age, osteoarthritis type, and geographical area. We used disability weights employed by the Peruvian Ministry of Health, and the last update issued by WHO. Results: Overall, EsSalud reported 17.9 new cases of osteoarthritis per 1000 patients per year. Annual incidence was 23.7/1000 among women, and 72.6/1000 in people above 60 years old. Incidence was 5.6/1000 for knee osteoarthritis and 1.1/1000 for hip. According to the 1994 WHO method, there were 399,884 DALYs or 36.6 DALYs/1000 patients per year due to osteoarthritis. 12.4 and 2.2 DALYs/1000 patients per-year were estimated for knee and hip osteoarthritis, respectively. Using the 2015 GBD method, there were 1,037,865 DALYs or 94.9 DALYs/1000 patients per year. 31.4 and 5.3 DALYs/1000 patients per year were calculated for knee and hip osteoarthritis, respectively. Conclusions: In the Peruvian social health insurance subsystem, hip, knee, and unspecified osteoarthritis produced a high burden of disease, especially among women and patients over 60. The 2015 GBD methodology yields values almost three times higher than the original recommendations.

SUBMITTER: Araujo-Castillo RV

PROVIDER: S-EPMC7443783 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Burden of disease due to hip, knee, and unspecified osteoarthritis in the Peruvian social health insurance system (EsSalud), 2016.

Araujo-Castillo Roger V RV Culquichicón Carlos C Solis Condor Risof R

F1000Research 20200403

<b>Introduction:</b> Since its introduction by the World Health Organization (WHO), the concept of burden of disease has been evolving. The current method uses life expectancy projected to 2050 and does not consider age-weighting and time-discounting. Our aim is to estimate the burden of disease due to hip, knee, and unspecified osteoarthritis using this new method in the Peruvian Social Health Insurance System (EsSalud) during 2016. <b>Methods:</b> We followed the original 1994 WHO study and th ...[more]

PMID: 32864102

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Project description:BackgroundOsteoarthritis (OA) is a leading cause of disability and pain especially among older adults, but it is also known to affect working age individuals, often leading to reduced productivity and increased healthcare usage. The aim of this study was to determine the burden of hip and knee OA in Finnish occupational healthcare.MethodsThis was a retrospective registry study utilizing the electronic medical records of the largest private and occupational healthcare provider in Finland. All consented patients with hip or knee OA were identified. A subcohort of occupational healthcare (OCH) patients was then compared to an age- and gender-matched control group without OA. Patient demographics including comorbidities were determined and healthcare contacts, medication prescriptions, and sick leaves were compared between the two groups. The study period was from January 1st, 2012 to April 30th, 2020.Results51,068 patients with hip or knee OA were identified (all OA cohort) and 35,109 of these formed the occupational healthcare subcohort. Most of the OA patients were female and belonged to the age group 50-59 years. The point prevalence of hip/knee OA at the end of the study period was 5.6% for the occupational healthcare subcohort. OA patients had 2.2 times more healthcare contacts and 2.8 times more overall sick leave days compared to the age- and gender-matched control cohort. Etoricoxib was the most commonly prescribed medication at OA-related visits (21.8% of patients). Opioids were prescribed to 10.6% of patients at OA-related visits and the most prescribed opioid was a combination of codeine and paracetamol (4.8% of patients). 5054 OA patients (14.4%) had a contraindication for non-steroidal anti-inflammatory drugs (NSAIDs).ConclusionsThis retrospective registry study utilizing real-world data provides new evidence on the disease burden of hip or knee osteoarthritis from the electronic medical records of Finnish occupational healthcare customers. OA patients had more comorbidities, more healthcare contacts, more sick leave days, and more analgesic prescriptions compared to an age- and gender-matched control cohort without OA.

Project description:Reduced external knee adduction moments in the second half of stance after total hip replacement have been reported in hip osteoarthritis patients. This reduction is thought to shift the load from the medial to the lateral knee compartment and as such increase the risk for knee osteoarthritis. The knee adduction moment is a surrogate for the load distribution between the medial and lateral compartments of the knee and not a valid measure for the tibiofemoral contact forces which are the result of externally applied forces and muscle forces. The purpose of this study was to investigate whether the distribution of the tibiofemoral contact forces over the knee compartments in unilateral hip osteoarthritis patients 1 year after receiving a primary total hip replacement differs from healthy controls. Musculoskeletal modeling on gait was performed in OpenSim using the detailed knee model of Lerner et al. (2015) for 19 patients as well as for 15 healthy controls of similar age. Knee adduction moments were calculated by the inverse dynamics analysis, medial and lateral tibiofemoral contact forces with the joint reaction force analysis. Moments and contact forces of patients and controls were compared using Statistical Parametric Mapping two-sample t-tests. Knee adduction moments and medial tibiofemoral contact forces of both the ipsi- and contralateral leg were not significantly different compared to healthy controls. The contralateral leg showed 14% higher medial tibiofemoral contact forces compared to the ipsilateral (operated) leg during the second half of stance. During the first half of stance, the lateral tibiofemoral contact force of the contralateral leg was 39% lower and the ratio 32% lower compared to healthy controls. In contrast, during the second half of stance the forces were significantly higher (39 and 26%, respectively) compared to healthy controls. The higher ratio indicates a changed distribution whereas the increased lateral tibiofemoral contact forces indicate a higher lateral knee joint loading in the contralateral leg in OA patients after total hip replacement (THR). Musculoskeletal modeling using a detailed knee model can be useful to detect differences in the load distribution between the medial and lateral knee compartment which cannot be verified with the knee adduction moment.

Dataset Information

Burden of disease due to hip, knee, and unspecified osteoarthritis in the Peruvian social health insurance system (EsSalud), 2016.

Publications

Burden of disease due to hip, knee, and unspecified osteoarthritis in the Peruvian social health insurance system (EsSalud), 2016.

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