Health-related quality of life and costs in patients with osteoarthritis on waiting list for total knee replacement

SummaryObjectivesTo determine: (1) health-related quality of life (HRQL) in patients with severe osteoarthritis (OA) on a waiting list (WL) for total knee replacement (TKR) and to compare it with general Spanish reference population values (RPVs); (2) the influence of sociodemographic and clinical variables on HRQL dimensions and (3) the use and cost of resources related to knee OA.MethodsCross-sectional study. HRQL was measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Medical Outcomes Study 36 Item Short Form Health Survey (SF-36) questionnaires. Sociodemographic and disease characteristics, body mass index, pharmacological treatment and the cost and use of economic resources related to knee OA during the 6-months previous to baseline were recorded. Relationships were analyzed using linear regression models.ResultsOne hundred consecutive outpatients (71 female, mean age 71 ± 6.89 years, mean disease duration 11.84 ± 10.52 years) were included. Patients showed worse HRQL measured by SF-36 than the reference population, mainly in physical function, physical role and bodily pain dimensions (P < 0.05). A low number of visits to physicians were recorded (mean 0.62 ± 1.04). Total mean direct medical costs were 200.24 € (95%CI 167.08–233.40) and total mean direct non-medical costs were 1234.87 € (95%CI 812.74–1657.00).ConclusionsThe HRQL of patients on a WL is worse than that of the reference population. The main costs of these patients were on non-medical resources, mainly due to functional limitations and loss of autonomy. The results suggest little compliance with knee OA management guidelines.