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原发性膝骨关节炎患者疼痛缓解不充分。

Inadequate pain relief among patients with primary knee osteoarthritis.

作者信息

Laires Pedro A, Laíns Jorge, Miranda Luís C, Cernadas Rui, Rajagopalan Srini, Taylor Stephanie D, Silva José C

机构信息

Merck, Sharp & Dohme, Oeiras, Portugal.

Centro de Medicina de Reabilitação da Região Centro, Tocha, Portugal.

出版信息

Rev Bras Reumatol Engl Ed. 2017 May-Jun;57(3):229-237. doi: 10.1016/j.rbre.2016.11.005. Epub 2016 Dec 5.

Abstract

BACKGROUND

Despite the widespread treatments for osteoarthritis (OA), data on treatment patterns, adequacy of pain relief, and quality of life are limited. The prospective multinational Survey of Osteoarthritis Real World Therapies (SORT) was designed to investigate these aspects.

OBJECTIVES

To analyze the characteristics and the patient reported outcomes of the Portuguese dataset of SORT at the start of observation.

METHODS

Patients ≥50 years with primary knee OA who were receiving oral or topical analgesics were eligible. Patients were enrolled from seven healthcare centers in Portugal between January and December 2011. Pain and function were evaluated using the Brief Pain Inventory (BPI) and WOMAC. Quality of life was assessed using the 12-Item Short Form Health Survey (SF-12). Inadequate pain relief (IPR) was defined as a score >4/10 on item 5 of the BPI.

RESULTS

Overall, 197 patients were analyzed. The median age was 67.0 years and 78.2% were female. Mean duration of knee OA was 6.2 years. IPR was reported by 51.3% of patients. Female gender (adjusted odds ratio - OR 2.15 [95%CI 1.1, 4.5]), diabetes (OR 3.1 [95%CI 1.3, 7.7]) and depression (OR 2.24 [95%CI 1.2, 4.3]) were associated with higher risk of IPR. Patients with IPR reported worst outcomes in all dimensions of WOMAC (p<0.001) and in all eight domains and summary components of SF-12 (p<0.001).

CONCLUSIONS

Our findings indicate that improvements are needed in the management of pain in knee OA in order to achieve better outcomes in terms of pain relief, function and quality of life.

摘要

背景

尽管骨关节炎(OA)有广泛的治疗方法,但关于治疗模式、疼痛缓解的充分性和生活质量的数据有限。前瞻性跨国骨关节炎真实世界治疗调查(SORT)旨在调查这些方面。

目的

分析SORT葡萄牙数据集在观察开始时的特征和患者报告的结局。

方法

年龄≥50岁、患有原发性膝骨关节炎且正在接受口服或外用镇痛药治疗的患者符合条件。2011年1月至12月期间,从葡萄牙的七个医疗中心招募患者。使用简明疼痛量表(BPI)和WOMAC评估疼痛和功能。使用12项简短健康调查(SF-12)评估生活质量。疼痛缓解不足(IPR)定义为BPI第5项得分>4/10。

结果

总体而言,分析了197例患者。中位年龄为67.0岁,78.2%为女性。膝骨关节炎的平均病程为6.2年。51.3%的患者报告有疼痛缓解不足。女性(调整后的优势比-OR 2.15 [95%CI 1.1, 4.5])、糖尿病(OR 3.1 [95%CI 1.3, 7.7])和抑郁症(OR 2.24 [95%CI 1.2, 4.3])与疼痛缓解不足的风险较高相关。疼痛缓解不足的患者在WOMAC的所有维度(p<0.001)以及SF-12的所有八个领域和总结成分中报告的结局最差(p<0.001)。

结论

我们的研究结果表明,为了在疼痛缓解、功能和生活质量方面取得更好的结局,膝骨关节炎的疼痛管理需要改进。

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