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Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study

OBJECTIVE: As part of the STAR Programme, a comprehensive study exploring long-term pain after surgery, we investigated how pain and function, health-related quality of life (HRQL), and healthcare resource use evolved over 5 years after total knee replacement (TKR) for those with and without chronic...

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Autores principales: Cole, Sophie, Kolovos, Spyros, Soni, Anushka, Delmestri, Antonella, Sanchez-Santos, Maria T, Judge, Andrew, Arden, Nigel K, Beswick, Andrew David, Wylde, Vikki, Gooberman-Hill, Rachael, Pinedo-Villanueva, Rafael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039409/
https://www.ncbi.nlm.nih.gov/pubmed/35470197
http://dx.doi.org/10.1136/bmjopen-2021-058044
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author Cole, Sophie
Kolovos, Spyros
Soni, Anushka
Delmestri, Antonella
Sanchez-Santos, Maria T
Judge, Andrew
Arden, Nigel K
Beswick, Andrew David
Wylde, Vikki
Gooberman-Hill, Rachael
Pinedo-Villanueva, Rafael
author_facet Cole, Sophie
Kolovos, Spyros
Soni, Anushka
Delmestri, Antonella
Sanchez-Santos, Maria T
Judge, Andrew
Arden, Nigel K
Beswick, Andrew David
Wylde, Vikki
Gooberman-Hill, Rachael
Pinedo-Villanueva, Rafael
author_sort Cole, Sophie
collection PubMed
description OBJECTIVE: As part of the STAR Programme, a comprehensive study exploring long-term pain after surgery, we investigated how pain and function, health-related quality of life (HRQL), and healthcare resource use evolved over 5 years after total knee replacement (TKR) for those with and without chronic pain 1 year after their primary surgery. METHODS: We used data from the Clinical Outcomes in Arthroplasty Study prospective cohort study, which followed patients undergoing TKR from two English hospitals for 5 years. Chronic pain was defined using the Oxford Knee Score Pain Subscale (OKS-PS) where participants reporting a score of 14 or lower were classified as having chronic pain 1-year postsurgery. Pain and function were measured with the OKS, HRQL using the EuroQoL-5 Dimension, resource use from yearly questionnaires, and costs estimated from a healthcare system perspective. We analysed the changes in OKS-PS, HRQL and resource use over a 5-year follow-up period. Multiple imputation accounted for missing data. RESULTS: Chronic pain was reported in 70/552 operated knees (12.7%) 1 year after surgery. The chronic pain group had worse pain, function and HRQL presurgery and postsurgery than the non-chronic pain group. Those without chronic pain markedly improved right after surgery, then plateaued. Those with chronic pain improved slowly but steadily. Participants with chronic pain reported greater healthcare resource use and costs than those without, especially 1 year after surgery, and mostly from hospital readmissions. 64.7% of those in chronic pain recovered during the following 4 years, while 30.9% fluctuated in and out of chronic pain. CONCLUSION: Although TKR is often highly beneficial, some patients experienced chronic pain postsurgery. Although many fluctuated in their pain levels and most recovered over time, identifying people most likely to have chronic pain and supporting their recovery would benefit patients and healthcare systems.
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spelling pubmed-90394092022-05-06 Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study Cole, Sophie Kolovos, Spyros Soni, Anushka Delmestri, Antonella Sanchez-Santos, Maria T Judge, Andrew Arden, Nigel K Beswick, Andrew David Wylde, Vikki Gooberman-Hill, Rachael Pinedo-Villanueva, Rafael BMJ Open Health Economics OBJECTIVE: As part of the STAR Programme, a comprehensive study exploring long-term pain after surgery, we investigated how pain and function, health-related quality of life (HRQL), and healthcare resource use evolved over 5 years after total knee replacement (TKR) for those with and without chronic pain 1 year after their primary surgery. METHODS: We used data from the Clinical Outcomes in Arthroplasty Study prospective cohort study, which followed patients undergoing TKR from two English hospitals for 5 years. Chronic pain was defined using the Oxford Knee Score Pain Subscale (OKS-PS) where participants reporting a score of 14 or lower were classified as having chronic pain 1-year postsurgery. Pain and function were measured with the OKS, HRQL using the EuroQoL-5 Dimension, resource use from yearly questionnaires, and costs estimated from a healthcare system perspective. We analysed the changes in OKS-PS, HRQL and resource use over a 5-year follow-up period. Multiple imputation accounted for missing data. RESULTS: Chronic pain was reported in 70/552 operated knees (12.7%) 1 year after surgery. The chronic pain group had worse pain, function and HRQL presurgery and postsurgery than the non-chronic pain group. Those without chronic pain markedly improved right after surgery, then plateaued. Those with chronic pain improved slowly but steadily. Participants with chronic pain reported greater healthcare resource use and costs than those without, especially 1 year after surgery, and mostly from hospital readmissions. 64.7% of those in chronic pain recovered during the following 4 years, while 30.9% fluctuated in and out of chronic pain. CONCLUSION: Although TKR is often highly beneficial, some patients experienced chronic pain postsurgery. Although many fluctuated in their pain levels and most recovered over time, identifying people most likely to have chronic pain and supporting their recovery would benefit patients and healthcare systems. BMJ Publishing Group 2022-04-25 /pmc/articles/PMC9039409/ /pubmed/35470197 http://dx.doi.org/10.1136/bmjopen-2021-058044 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Health Economics
Cole, Sophie
Kolovos, Spyros
Soni, Anushka
Delmestri, Antonella
Sanchez-Santos, Maria T
Judge, Andrew
Arden, Nigel K
Beswick, Andrew David
Wylde, Vikki
Gooberman-Hill, Rachael
Pinedo-Villanueva, Rafael
Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study
title Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study
title_full Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study
title_fullStr Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study
title_full_unstemmed Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study
title_short Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study
title_sort progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study
topic Health Economics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039409/
https://www.ncbi.nlm.nih.gov/pubmed/35470197
http://dx.doi.org/10.1136/bmjopen-2021-058044
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