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Martín-Fernández J, García -Maroto R, Bilbao A, García-Pérez L, Gutiérrez-Teira B, Molina-Siguero A, Arenaza JC, Ramos-García V, Rodríguez-Martínez G, Sánchez-Jiménez FJ, Ariza-Cardiel G. Impact of lower limb osteoarthritis on health-related quality of life: A cross-sectional study to estimate the expressed loss of utility in the Spanish population. PLoS One 2020; 15:e0228398. [PMID: 31978194 PMCID: PMC6980637 DOI: 10.1371/journal.pone.0228398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/14/2020] [Indexed: 01/27/2023] Open
Abstract
Objective Osteoarthritis of the lower limb (OALL) worsens health-related quality of life (HRQL), but this impact has not been quantified with standardized measures. We intend to evaluate the impact of OALL on HRQL through measures based on individual preferences in comparison to the general population. Methods A cross-sectional study was designed. A total of 6234 subjects aged 50 years or older without OALL were selected from the Spanish general population (National Health Survey 2011–12). An opportunistic sample of patients aged 50 years or older diagnosed with hip (n = 331) or knee osteoarthritis (n = 393), using the American Rheumatism Association criteria, was recruited from six hospitals and 21 primary care centers in Vizcaya, Madrid and Tenerife between January and December 2015. HRQL was measured with the EQ-5D-5L, and the results were transformed into utility scores. Sociodemographic variables (age, sex, social group, cohabitation), number of chronic diseases, and body mass index were considered. The clinical stage of OALL was collected using the Western Ontario and McMaster Universities Osteoarthritis Index and the Oxford hip score and Oxford knee score. Generalized linear models were constructed using the utility index as the dependent variable. Results HRQL expressed by OALL patients was significantly worse than this of the general population. After adjustment for sociodemographic and clinical characteristics, the mean utility loss was -0.347 (95% CI: -0.390, -0.303) for osteoarthritis of the hip and -0.295 (95% CI: -0.336, -0.255) for osteoarthritis of the knee. OALL patients who were treated at a hospital had an additional utility loss of -0.112 (95% CI: -0.158, -0.065). Conclusion OALL has a great impact on HRQL. People with OALL perceive a utility loss of approximately 0.3 points compared to the general population without osteoarthritis, which is very high in relation to the utility loss reported for other chronic diseases and for arthritis in general.
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Affiliation(s)
- Jesús Martín-Fernández
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Oeste, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Spain
- * E-mail:
| | - Roberto García -Maroto
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Clínico San Carlos, Servicio Madrileño de Salud, Madrid, Spain
- Doctorando en el Programa de Investigación en Ciencias Médico Quirúrgicas, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Amaia Bilbao
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Spain
- Osakidetza, Hospital Universitario Basurto, Unidad de Investigación, Bilbao, Spain
- Instituto de Investigación en Servicios de Salud Kronikgune, Barakaldo, Spain
| | - Lidia García-Pérez
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria, Spain
| | - Blanca Gutiérrez-Teira
- Centro de Salud El Soto, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Antonio Molina-Siguero
- Centro de Salud Presentación Sabio, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Juan Carlos Arenaza
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Spain
- Osakidetza, Hospital Universitario Basurto, Servicio de Traumatología y Cirugía Ortopédica, Bilbao, Spain
| | - Vanesa Ramos-García
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria, Spain
| | - Gemma Rodríguez-Martínez
- Centro de Salud Infante Don Luis, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Fco Javier Sánchez-Jiménez
- Centro de Salud Gregorio Marañón, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Gloria Ariza-Cardiel
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Oeste, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Spain
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Martín-Fernández J, García-Maroto R, Sánchez-Jiménez FJ, Bau-González A, Valencia-García H, Gutiérrez-Teira B, Arenaza JC, García-Pérez L, Linertová R, Bilbao A. Validation of the Spanish version of the Oxford knee score and assessment of its utility to characterize quality of life of patients suffering from knee osteoarthritis: a multicentric study. Health Qual Life Outcomes 2017; 15:186. [PMID: 28962613 PMCID: PMC5622506 DOI: 10.1186/s12955-017-0761-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 09/19/2017] [Indexed: 12/27/2022] Open
Abstract
Background Knee osteoarthritis (OA) represents a heavy burden for patients and the society as a whole. The Oxford Knee Score (OKS) is a well known tool to assess the quality of life in patients with Knee OA. The purpose of this study was to analyze the psychometric properties of the Spanish version of the OKS, including its reliability, validity, and responsiveness. Methods Prospective observational study that included 397 patients diagnosed with knee OA according to the criterion of the American Rheumatism Association, which were recruited in 3 different Spanish regions. Their self-perceived health-related quality of life (HRQL) was assessed through 3 questionnaires: a generic one (the EQ-5D-5 L) and two specific ones adapted to Spanish (the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Oxford Knee Score (OKS). The follow-up period was 6 months, and the acceptability of the OKS was evaluated, together with its psychometric properties, presence of ceiling and floor effects, validity, reliability, and sensitivity to change. Results The OKS was fully answered in 99.5% of cases, with no evidence of ceiling or floor effects. Its factor structure can be explained in a single dimension. Its discriminating capacity was very good compared to the groups generated by the WOMAC and the EQ-5D-5 L. The correlation of the OKS with the dimensions of the latter questionnaires was around 0.7. The test-retest reliability was excellent (ICC 0.993; CI 95%: 0.990–0.995) and so was its internal consistency (Cronbach’s α = 0.920). The effect size was 0.7 for moderate improvements in the HQRL, which is similar to that of the dimensions of the WOMAC and greater than for the EQ-5D-5 L. The minimum clinically significant difference that was detected by the questionnaire was 6.1 points, and the minimum detectable change was 4.4 points. Conclusions The Spanish-adapted version of the OKS is a useful, valid tool for assessing the perceived HRQL in patients suffering from knee OA, with psychometric properties similar to the WOMAC, and that allows for discriminating the patient’s condition at a particular moment as well as for appraising changes over time. Electronic supplementary material The online version of this article (10.1186/s12955-017-0761-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jesús Martín-Fernández
- C° Villamanta (C.S. Navalcarnero). Gerencia Asistencial de Atención Primaria. Servicio Madrileño de Salud, Avda Libertad 21 s/n, Villamanta, 28610, Madrid, Spain. .,Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos, Avda Atenas s/n, 28922 Alcorcón, Madrid, Spain. .,Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.
| | - Roberto García-Maroto
- Servicio de Traumatología. Hospital Universitario Clínico San Carlos. Servicio Madrileño de Salud, C/ Profesor Martín Lagos, S/N, 28040, Madrid, Spain
| | - Fco Javier Sánchez-Jiménez
- C.S. Gregorio Marañón. Gerencia Asistencial de Atención Primaria. Servicio Madrileño de Salud, Calle Polvoranca, 65. 28923 Alcorcón, Madrid, Spain
| | - Alonso Bau-González
- Servicio de Traumatología. Hospital Universitario Rey Juan Carlos, C/ Gladiolo s/n, 28933, Móstoles, Madrid, Spain
| | - Homero Valencia-García
- Servicio de Traumatología. Hospital Universitario Fundación Alcorcón, C/ Budapest, 1 28922 - Alcorcón, Madrid, Spain
| | - Blanca Gutiérrez-Teira
- C. S. El Soto. Gerencia Asistencial de Atención Primaria. Servicio Madrileño de Salud, Avenida Olímpica, 38, 28935, Móstoles, (Bizkaia), Spain
| | - Juan Carlos Arenaza
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.,Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Basurto (Osakidetza), Avda. Montevideo, 18, 48013, Bilbao, (Bizkaia), Spain
| | - Lidia García-Pérez
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.,Fundación Canaria de Investigación Sanitaria (FUNCANIS), Camino Candelaria N° 44, 1ª planta, 38109, El Rosario (Santa Cruz de Tenerife), Spain
| | - Renata Linertová
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.,Fundación Canaria de Investigación Sanitaria (FUNCANIS), Camino Candelaria N° 44, 1ª planta, 38109, El Rosario (Santa Cruz de Tenerife), Spain
| | - Amaia Bilbao
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.,Unidad de Investigación, Hospital Universitario Basurto (Osakidetza), Avda. Montevideo, 18, 48013, Bilbao, (Bizkaia), Spain
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