The Health Economics Research Unit, Menzies Institute for Medical Research, University of Tasmania, Hobart.
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Rheumatology (Oxford). 2021 Jul 1;60(7):3352-3359. doi: 10.1093/rheumatology/keaa787.
To describe the impact of OA on health-related quality of life (HRQoL) in the forms of health state utilities (HSUs) and health-dimension scores, and to compare the longitudinal changes in HRQoL for people with and without OA, using an Australian population-based longitudinal cohort.
Participants of the Tasmanian Older Adult Cohort with data on OA diagnosis and HRQoL were included [interviewed at baseline (n = 1093), 2.5 years (n = 871), 5 years (n = 760) and 10 years (n = 562)]. HRQoL was assessed using the Assessment of Quality of Life four-dimensions and analysed using multivariable linear mixed regressions.
Compared with participants without OA, HSUs for those with OA were 0.07 (95% confidence interval: 0.09, 0.05) units lower on average over 10 years. HSUs for participants with knee and/or hip OA were similar to those with other types of OA at the 2.5 year follow-up and then diverged, with HSUs of the former being up to 0.09 units lower than the latter. Those with OA had lower scores for psychological wellness, independent living and social relationships compared with those without OA. Independent living and social relationships were mainly impacted by knee and/or hip OA, with the effect on the former increasing over time.
Interventions to improve HRQoL should be tailored to specific OA types, health dimensions, and times. Support for maintaining psychological wellness should be provided, irrespective of OA type and duration. However, support for maintaining independent living could be more relevant to knee and/or hip OA patients living with the disease for longer.
描述 OA 对健康相关生活质量(HRQoL)的影响,表现为健康状态效用(HSU)和健康维度评分,并使用澳大利亚人群纵向队列比较有和无 OA 人群的 HRQoL 纵向变化。
纳入 Tasmanian 老年队列研究中具有 OA 诊断和 HRQoL 数据的参与者(基线访谈[n=1093]、2.5 年随访[n=871]、5 年随访[n=760]和 10 年随访[n=562])。使用生活质量评估四维度评估 HRQoL,并使用多变量线性混合回归进行分析。
与无 OA 参与者相比,OA 参与者的 HSU 在 10 年内平均低 0.07(95%置信区间:0.09,0.05)单位。膝关节和/或髋关节 OA 参与者的 HSU 在 2.5 年随访时与其他类型 OA 参与者相似,然后出现差异,前者的 HSU 比后者低 0.09 单位。与无 OA 参与者相比,OA 参与者的心理幸福感、独立生活和社会关系评分较低。独立生活和社会关系主要受到膝关节和/或髋关节 OA 的影响,其对前者的影响随时间增加。
应根据特定的 OA 类型、健康维度和时间来定制改善 HRQoL 的干预措施。无论 OA 类型和持续时间如何,都应提供对维持心理健康的支持。然而,对维持独立生活的支持可能更与膝关节和/或髋关节 OA 患者有关,因为他们患有该疾病的时间更长。