University of Leeds, Leeds, UK.
Pfizer Ltd, Surrey, UK.
Scand J Rheumatol. 2023 Jul;52(4):353-363. doi: 10.1080/03009742.2022.2058168. Epub 2022 May 19.
To understand treatment patterns and healthcare resource utilization (HCRU) related to osteoarthritis (OA) disease severity in patients in five European countries.
Data were drawn from the Adelphi OA Disease Specific Programme™ (2017-18). Physicians classified their patients as having mild, moderate, or severe OA, and provided details on their current prescribed therapy and HCRU, including healthcare professional (HCP) consultations, diagnostics and testing, and hospitalizations. Comparisons between disease severity groups were made using analysis of variance and chi-squared tests.
The study included 489 physicians (primary care physicians, rheumatologists, orthopaedic surgeons) reporting on 3596 OA patients: 24% mild, 53% moderate, and 23% severe disease. Both physicians and patients reported decreasing satisfaction with treatment with greater disease severity, despite the number of classes of prescribed drugs and increased use of opioids, which were used in almost half of patients with severe OA. For patients whose treatment was not effective, physicians prescribed the same therapeutic options, which were cycled in subsequent treatment lines, with multiple treatment regimens being commonly used. Patients with greater symptom severity also had more physician consultations, while the numbers of tests/imaging, predominantly X-rays, conducted to diagnose or monitor OA increased significantly with disease severity. The type of HCP involvement in patient management also varied by OA severity.
Across five European countries, the use of both non-pharmacological and pharmacological treatments increases with greater disease severity. Those with more severe disease place a greater demand on healthcare resources, with HCP consultations, tests, and hospital visits increasing with severity.
了解 5 个欧洲国家中骨关节炎（OA）疾病严重程度患者的治疗模式和医疗资源利用（HCRU）情况。
数据来自 Adelphi OA 疾病专项计划™（2017-18 年）。医生将患者分为轻度、中度或重度 OA，并详细说明其当前的处方治疗和 HCRU，包括医疗保健专业人员（HCP）的咨询、诊断和检查以及住院治疗。使用方差分析和卡方检验比较疾病严重程度组之间的差异。
研究纳入了 489 名医生（初级保健医生、风湿病医生、骨科医生），报告了 3596 名 OA 患者的情况：24%为轻度，53%为中度，23%为重度疾病。尽管处方药物的种类增加，并且使用了阿片类药物（几乎一半的重度 OA 患者使用），但医生和患者都报告随着疾病严重程度的增加，对治疗的满意度降低。对于治疗无效的患者，医生开出了相同的治疗选择，这些选择在后续治疗线中循环使用，通常会使用多种治疗方案。症状严重程度较高的患者也有更多的医生就诊，而用于诊断或监测 OA 的检查/影像学检查（主要是 X 光）的数量随着疾病严重程度显著增加。HCP 参与患者管理的类型也因 OA 严重程度而异。
在 5 个欧洲国家，随着疾病严重程度的增加，非药物和药物治疗的使用都有所增加。病情较重的患者对医疗资源的需求更大，HCP 咨询、检查和就诊次数随着病情严重程度的增加而增加。
