Impact of osteoarthritis disease severity on treatment patterns and healthcare resource use: analysis of real-world data

Abstract

Objective

To understand treatment patterns and healthcare resource utilization (HCRU) related to osteoarthritis (OA) disease severity in patients in five European countries.

Method

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.

Results

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.

Conclusions

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.

Acknowledgement

The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Disclosure statement

LA, CB, JCC, and AB are employees of Pfizer with stock and/or stock options. Lars Viktrup is an employee of Eli Lilly and Company and owns stock in Lilly. PGC has provided consultancies or attended speaker bureaus for AbbVie, Amgen, AstraZeneca, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Novartis, Pfizer, and UCB. Mia Berry and James Jackson are employees of Adelphi Real World and are paid consultants funded by Pfizer and Eli Lilly & Company.

Supplemental material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/03009742.2022.2058168

Additional information

Funding

Medical writing support was provided by K Ian Johnson of Harrogate House Consultancy on behalf of Adelphi Real World and was funded by Pfizer and Eli Lilly and Company. PGC is supported in part by the UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre.