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Published in: Health and Quality of Life Outcomes 1/2012

Open Access 01-12-2012 | Research

Impact of self-rated osteoarthritis severity in an employed population: Cross-sectional analysis of data from the national health and wellness survey

Authors: Marco daCosta DiBonaventura, Shaloo Gupta, Margaret McDonald, Alesia Sadosky, Dan Pettitt, Stuart Silverman

Published in: Health and Quality of Life Outcomes | Issue 1/2012

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Abstract

Background

Although osteoarthritis (OA) often affects older persons, it has a profound effect on individuals actively employed. Despite reports of reduced productivity among workers with OA, data are limited regarding the impact of OA among workers. The objective of this study was to evaluate the impact of self-rated OA severity on quality of life, healthcare resource utilization, productivity and costs in an employed population relative to employed individuals without OA.

Methods

This cross-sectional analysis used data derived from the 2009 National Health and Wellness Survey (NHWS). Multivariable analyses characterized outcomes and costs (direct medical costs and indirect) among workers (full-time, part-time, or self-employed) ≥ 20 years of age who were diagnosed with OA and who self-rated their OA severity as mild, moderate, or severe relative to workers without OA. Evaluated outcomes included productivity, assessed using the Work Productivity and Impairment (WPAI) scale; health-related quality of life, using the SF-12v2 Health Survey; and healthcare resource utilization.

Results

4,876 workers reported being diagnosed with OA (45.0% mild, 45.9% moderate, and 9.1% severe); 34,896 workers comprised the non-OA comparator cohort. There was a greater proportion of females in the OA cohort (55.5% vs 45.6%; P < 0.0001) and more individuals in the 40-64 year and ≥ 65 year age ranges (P < 0.0001). As OA severity increased, workers reported more frequent pain, poorer quality of life, greater use of specific healthcare resources (hospitalizations) and reduced productivity. All outcomes indicated a significantly greater burden among workers with OA relative to those without OA (P < 0.0001). Estimated total annual costs per worker were $9,801 for mild OA, $14,761 for moderate OA, $22,111 for severe OA compared with $7,901 for workers without OA (P < 0.0001).

Conclusions

Workers with OA were characterized by significant disease and economic burdens relative to workers without OA that substantially increased with greater self-rated OA severity. Greater levels of OA severity were associated with reductions in quality of life and productivity, and increases in healthcare resource utilization and costs.
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Literature
1.
go back to reference Centers for Disease Control and Prevention (CDC): Prevalence and most common causes of disability among adults--United States, 2005. MMWR Morb Mortal Wkly Rep 2009, 58: 421–426. Centers for Disease Control and Prevention (CDC): Prevalence and most common causes of disability among adults--United States, 2005. MMWR Morb Mortal Wkly Rep 2009, 58: 421–426.
3.
go back to reference Dominick KL, Ahern FM, Gold CH, Heller DA: Health-related quality of life and health service use among older adults with osteoarthritis. Arthritis Rheum 2004, 51: 326–331. 10.1002/art.20390CrossRefPubMed Dominick KL, Ahern FM, Gold CH, Heller DA: Health-related quality of life and health service use among older adults with osteoarthritis. Arthritis Rheum 2004, 51: 326–331. 10.1002/art.20390CrossRefPubMed
4.
go back to reference Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC: The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 2005, 44: 1531–1537. 10.1093/rheumatology/kei049CrossRef Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC: The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 2005, 44: 1531–1537. 10.1093/rheumatology/kei049CrossRef
5.
go back to reference Rabenda V, Manette C, Lemmens R, Mariani AM, Struvay N, Reginster JY: Direct and indirect costs attributable to osteoarthritis in active subjects. J Rheumatol 2006, 33: 1152–1158.PubMed Rabenda V, Manette C, Lemmens R, Mariani AM, Struvay N, Reginster JY: Direct and indirect costs attributable to osteoarthritis in active subjects. J Rheumatol 2006, 33: 1152–1158.PubMed
6.
go back to reference Cook C, Pietrobon R, Hegedus E: Osteoarthritis and the impact on quality of life health indicators. Rheumatol Int 2007, 27: 315–321. 10.1007/s00296-006-0269-2CrossRefPubMed Cook C, Pietrobon R, Hegedus E: Osteoarthritis and the impact on quality of life health indicators. Rheumatol Int 2007, 27: 315–321. 10.1007/s00296-006-0269-2CrossRefPubMed
7.
go back to reference Kotlarz H, Gunnarsson CL, Fang H, Rizzo JA: Insurer and out-of-pocket costs of osteoarthritis in the US: evidence from national survey data. Arthritis Rheum 2009, 60: 3546–3553. 10.1002/art.24984CrossRefPubMed Kotlarz H, Gunnarsson CL, Fang H, Rizzo JA: Insurer and out-of-pocket costs of osteoarthritis in the US: evidence from national survey data. Arthritis Rheum 2009, 60: 3546–3553. 10.1002/art.24984CrossRefPubMed
8.
go back to reference Kotlarz H, Gunnarsson CL, Fang H, Rizzo JA: Osteoarthritis and absenteeism costs: evidence from US National Survey Data. J Occup Environ Med 2010, 52: 263–268. 10.1097/JOM.0b013e3181cf00aaCrossRefPubMed Kotlarz H, Gunnarsson CL, Fang H, Rizzo JA: Osteoarthritis and absenteeism costs: evidence from US National Survey Data. J Occup Environ Med 2010, 52: 263–268. 10.1097/JOM.0b013e3181cf00aaCrossRefPubMed
9.
go back to reference White LA, Birnbaum HG, Kaltenboeck A, Tang J, Mallett D, Robinson RL: Employees with fibromyalgia: medical comorbidity, healthcare costs, and work loss. J Occup Environ Med 2008, 50: 13–24. 10.1097/JOM.0b013e31815cff4bCrossRefPubMed White LA, Birnbaum HG, Kaltenboeck A, Tang J, Mallett D, Robinson RL: Employees with fibromyalgia: medical comorbidity, healthcare costs, and work loss. J Occup Environ Med 2008, 50: 13–24. 10.1097/JOM.0b013e31815cff4bCrossRefPubMed
10.
go back to reference Kleinman N, Harnett J, Melkonian A, Lynch W, Kaplan-Machlis B, Silverman S: Burden of Fibromyalgia and Comparisons With Osteoarthritis in the Workforce. J Occup Environ Med 2009, 51: 1384–1393. 10.1097/JOM.0b013e3181bb808bCrossRefPubMed Kleinman N, Harnett J, Melkonian A, Lynch W, Kaplan-Machlis B, Silverman S: Burden of Fibromyalgia and Comparisons With Osteoarthritis in the Workforce. J Occup Environ Med 2009, 51: 1384–1393. 10.1097/JOM.0b013e3181bb808bCrossRefPubMed
11.
go back to reference daCosta DiBonaventura M, Gupta S, McDonald M, Sadosky A: Evaluating the health and economic impact of osteoarthritis pain in the workforce: results from the National Health and Wellness Survey. BMC Musculoskelet Disord 2011, 12: 83. 10.1186/1471-2474-12-83CrossRef daCosta DiBonaventura M, Gupta S, McDonald M, Sadosky A: Evaluating the health and economic impact of osteoarthritis pain in the workforce: results from the National Health and Wellness Survey. BMC Musculoskelet Disord 2011, 12: 83. 10.1186/1471-2474-12-83CrossRef
12.
go back to reference McDonald M, DiBonaventura MD, Ullman SJP: Musculoskeletal pain in the workforce: the effects of back, arthritis and fibromyalgia pain on quality of life and work productivity. J Occup Environ Med 2011, 53: 765–770. 10.1097/JOM.0b013e318222af81CrossRefPubMed McDonald M, DiBonaventura MD, Ullman SJP: Musculoskeletal pain in the workforce: the effects of back, arthritis and fibromyalgia pain on quality of life and work productivity. J Occup Environ Med 2011, 53: 765–770. 10.1097/JOM.0b013e318222af81CrossRefPubMed
13.
go back to reference Li X, Gignac MA, Anis AH: The indirect costs of arthritis resulting from unemployment, reduced performance, and occupational changes while at work. Med Care 2006, 44: 304–310. 10.1097/01.mlr.0000204257.25875.04CrossRefPubMed Li X, Gignac MA, Anis AH: The indirect costs of arthritis resulting from unemployment, reduced performance, and occupational changes while at work. Med Care 2006, 44: 304–310. 10.1097/01.mlr.0000204257.25875.04CrossRefPubMed
14.
go back to reference Gignac MA, Cao X, Lacaille D, Anis AH, Badley EM: Arthritis-related work transitions: a prospective analysis of reported productivity losses, work changes, and leaving the labor force. Arthritis Rheum 2008, 59: 1805–1813. 10.1002/art.24085CrossRefPubMed Gignac MA, Cao X, Lacaille D, Anis AH, Badley EM: Arthritis-related work transitions: a prospective analysis of reported productivity losses, work changes, and leaving the labor force. Arthritis Rheum 2008, 59: 1805–1813. 10.1002/art.24085CrossRefPubMed
15.
go back to reference Zhang W, Gignac MA, Beaton D, Tang K, Anis AH: Productivity loss due to presenteeism among patients with arthritis: estimates from 4 instruments. J Rheumatol 2010, 37: 1805–1814. 10.3899/jrheum.100123CrossRefPubMed Zhang W, Gignac MA, Beaton D, Tang K, Anis AH: Productivity loss due to presenteeism among patients with arthritis: estimates from 4 instruments. J Rheumatol 2010, 37: 1805–1814. 10.3899/jrheum.100123CrossRefPubMed
16.
go back to reference Zhang W, Koehoorn M, Anis AH: Work productivity among employed Canadians with arthritis. J Occup Environ Med 2010, 52: 872–877. 10.1097/JOM.0b013e3181ec7ac4CrossRefPubMed Zhang W, Koehoorn M, Anis AH: Work productivity among employed Canadians with arthritis. J Occup Environ Med 2010, 52: 872–877. 10.1097/JOM.0b013e3181ec7ac4CrossRefPubMed
17.
go back to reference Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R: Lost productive time and cost due to common pain conditions in the US workforce. JAMA 2003, 290: 2443–2454. 10.1001/jama.290.18.2443CrossRefPubMed Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R: Lost productive time and cost due to common pain conditions in the US workforce. JAMA 2003, 290: 2443–2454. 10.1001/jama.290.18.2443CrossRefPubMed
18.
go back to reference Hutchings A, Calloway M, Choy E, Hooper M, Hunter DJ, Jordan JM, Zhang Y, Baser O, Long S, Palmer L: The Longitudinal Examination of Arthritis Pain (LEAP) study: relationships between weekly fluctuations in patient-rated joint pain and other health outcomes. J Rheumatol 2007, 34: 2291–2300.PubMed Hutchings A, Calloway M, Choy E, Hooper M, Hunter DJ, Jordan JM, Zhang Y, Baser O, Long S, Palmer L: The Longitudinal Examination of Arthritis Pain (LEAP) study: relationships between weekly fluctuations in patient-rated joint pain and other health outcomes. J Rheumatol 2007, 34: 2291–2300.PubMed
19.
go back to reference Sadosky A, Bushmakin A, Cappelleri JC, Lionberger DR: Relationship between patient-reported disease severity in osteoarthritis and self-reported pain, function, and work productivity. Arthritis Res Ther 2010, 12: R162. 10.1186/ar3121PubMedCentralCrossRefPubMed Sadosky A, Bushmakin A, Cappelleri JC, Lionberger DR: Relationship between patient-reported disease severity in osteoarthritis and self-reported pain, function, and work productivity. Arthritis Res Ther 2010, 12: R162. 10.1186/ar3121PubMedCentralCrossRefPubMed
20.
go back to reference Sadosky A, Cappelleri J, Bushmakin A, Lionberger D: Health status and disease severity in osteoarthritis. [abstract]. J Pain 2010, 11(Suppl):S1.CrossRef Sadosky A, Cappelleri J, Bushmakin A, Lionberger D: Health status and disease severity in osteoarthritis. [abstract]. J Pain 2010, 11(Suppl):S1.CrossRef
21.
go back to reference Bushmakin AG, Cappelleri JC, Taylor-Stokes G, Sayers J, Sadosky A, Carroll D, Gosden T, Emery P: Relationship between patient-reported disease severity and other clinical outcomes in osteoarthritis: a European perspective. J Med Econ 2011, 14: 381–389.CrossRefPubMed Bushmakin AG, Cappelleri JC, Taylor-Stokes G, Sayers J, Sadosky A, Carroll D, Gosden T, Emery P: Relationship between patient-reported disease severity and other clinical outcomes in osteoarthritis: a European perspective. J Med Econ 2011, 14: 381–389.CrossRefPubMed
22.
go back to reference Bolge SC, Doan JF, Kannan H, Baran RW: Association of insomnia with quality of life, work productivity, and activity impairment. Qual Life Res 2009, 18: 415–422. 10.1007/s11136-009-9462-6CrossRefPubMed Bolge SC, Doan JF, Kannan H, Baran RW: Association of insomnia with quality of life, work productivity, and activity impairment. Qual Life Res 2009, 18: 415–422. 10.1007/s11136-009-9462-6CrossRefPubMed
23.
go back to reference DiBonaventura MD, Wagner JS, Yuan Y, L'Italien G, Langley P, Ray Kim W: Humanistic and economic impacts of hepatitis C infection in the United States. J Med Econ 2010, 13: 709–718. 10.3111/13696998.2010.535576CrossRefPubMed DiBonaventura MD, Wagner JS, Yuan Y, L'Italien G, Langley P, Ray Kim W: Humanistic and economic impacts of hepatitis C infection in the United States. J Med Econ 2010, 13: 709–718. 10.3111/13696998.2010.535576CrossRefPubMed
24.
go back to reference Reilly MCZ, Dukes EMAS: The validity and reproducibility of a work productivity and activity impairment instrument. PharmacoEconomics 1993, 4: 353–365. 10.2165/00019053-199304050-00006CrossRefPubMed Reilly MCZ, Dukes EMAS: The validity and reproducibility of a work productivity and activity impairment instrument. PharmacoEconomics 1993, 4: 353–365. 10.2165/00019053-199304050-00006CrossRefPubMed
25.
go back to reference Ware JE Jr, Kosinski M, Turner-Bowker D, Gandek B: User's Manual for the SF-12v2™ Health Survey with a Supplement Documenting SF-12® Health Survey. Lincoln, RI: QualityMetric Incorporated; 2002. Ware JE Jr, Kosinski M, Turner-Bowker D, Gandek B: User's Manual for the SF-12v2™ Health Survey with a Supplement Documenting SF-12® Health Survey. Lincoln, RI: QualityMetric Incorporated; 2002.
26.
go back to reference Brazier J, Roberts J, Deverill M: The estimation of a preference-based measure of health from the SF-36. J Health Econ 2002, 21: 271–292. 10.1016/S0167-6296(01)00130-8CrossRefPubMed Brazier J, Roberts J, Deverill M: The estimation of a preference-based measure of health from the SF-36. J Health Econ 2002, 21: 271–292. 10.1016/S0167-6296(01)00130-8CrossRefPubMed
30.
go back to reference Lofland JH, Pizzi L, Frick KD: A review of health-related workplace productivity loss instruments. PharmacoEconomics 2004, 22: 165–184. 10.2165/00019053-200422030-00003CrossRefPubMed Lofland JH, Pizzi L, Frick KD: A review of health-related workplace productivity loss instruments. PharmacoEconomics 2004, 22: 165–184. 10.2165/00019053-200422030-00003CrossRefPubMed
32.
go back to reference Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987, 40: 373–383. 10.1016/0021-9681(87)90171-8CrossRefPubMed Charlson ME, Pompei P, Ales KL, MacKenzie CR: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987, 40: 373–383. 10.1016/0021-9681(87)90171-8CrossRefPubMed
33.
go back to reference Cohen J: Statistical Power Analysis for the Behavioral Sciences. 2nd edition. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. Cohen J: Statistical Power Analysis for the Behavioral Sciences. 2nd edition. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
35.
go back to reference Walters SJ, Brazier JE: What is the relationship between the minimally important difference and health state utility values? The case of the SF-6D. Health Qual Life Outcomes 2003, 1: 4. 10.1186/1477-7525-1-4PubMedCentralCrossRefPubMed Walters SJ, Brazier JE: What is the relationship between the minimally important difference and health state utility values? The case of the SF-6D. Health Qual Life Outcomes 2003, 1: 4. 10.1186/1477-7525-1-4PubMedCentralCrossRefPubMed
36.
go back to reference Hays RD, Morales LS: The RAND-36 measure of health-related quality of life. Ann Med 2001, 33: 350–357. 10.3109/07853890109002089CrossRefPubMed Hays RD, Morales LS: The RAND-36 measure of health-related quality of life. Ann Med 2001, 33: 350–357. 10.3109/07853890109002089CrossRefPubMed
37.
go back to reference White AG, Birnbaum HG, Janagap CC, Buteau L, Schein J: Direct and indirect costs of pain therapy for osteoarthritis in an insured population in the United States. J Occup Environ Med 2008, 50: 998–1005. 10.1097/JOM.0b013e3181715111CrossRefPubMed White AG, Birnbaum HG, Janagap CC, Buteau L, Schein J: Direct and indirect costs of pain therapy for osteoarthritis in an insured population in the United States. J Occup Environ Med 2008, 50: 998–1005. 10.1097/JOM.0b013e3181715111CrossRefPubMed
38.
go back to reference Ricci JA, Stewart WF, Chee E, Leotta C, Foley K, Hochberg MC: Pain exacerbation as a major source of lost productive time in US workers with arthritis. Arthritis Rheum 2005, 53: 673–681. 10.1002/art.21453CrossRefPubMed Ricci JA, Stewart WF, Chee E, Leotta C, Foley K, Hochberg MC: Pain exacerbation as a major source of lost productive time in US workers with arthritis. Arthritis Rheum 2005, 53: 673–681. 10.1002/art.21453CrossRefPubMed
39.
go back to reference Benyon K, Hill S, Zadurian N, Mallen C: Coping strategies and self-efficacy as predictors of outcome in osteoarthritis: a systematic review. Musculoskeletal Care 2010, 8: 224–236. 10.1002/msc.187CrossRefPubMed Benyon K, Hill S, Zadurian N, Mallen C: Coping strategies and self-efficacy as predictors of outcome in osteoarthritis: a systematic review. Musculoskeletal Care 2010, 8: 224–236. 10.1002/msc.187CrossRefPubMed
40.
go back to reference Trouillet R, Gana K, Lourel M, Fort I: Predictive value of age for coping: the role of self-efficacy, social support satisfaction and perceived stress. Aging Ment Health 2009, 13: 357–366. 10.1080/13607860802626223CrossRefPubMed Trouillet R, Gana K, Lourel M, Fort I: Predictive value of age for coping: the role of self-efficacy, social support satisfaction and perceived stress. Aging Ment Health 2009, 13: 357–366. 10.1080/13607860802626223CrossRefPubMed
41.
go back to reference Maetzel A, Li LC, Pencharz J, Tomlinson G, Bombardier C: The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study. Ann Rheum Dis 2004, 63: 395–401. 10.1136/ard.2003.006031PubMedCentralCrossRefPubMed Maetzel A, Li LC, Pencharz J, Tomlinson G, Bombardier C: The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study. Ann Rheum Dis 2004, 63: 395–401. 10.1136/ard.2003.006031PubMedCentralCrossRefPubMed
42.
go back to reference Xie F: The need for standardization: a literature review of indirect costs of rheumatoid arthritis and osteoarthritis. Arthritis Rheum 2008, 59: 1027–1033. 10.1002/art.23825CrossRefPubMed Xie F: The need for standardization: a literature review of indirect costs of rheumatoid arthritis and osteoarthritis. Arthritis Rheum 2008, 59: 1027–1033. 10.1002/art.23825CrossRefPubMed
43.
go back to reference Allen KD, Chen JC, Callahan LF, Golightly YM, Helmick CG, Renner JB, Jordan JM: Associations of occupational tasks with knee and hip osteoarthritis: the Johnston County Osteoarthritis Project. J Rheumatol 2010, 37: 842–850. 10.3899/jrheum.090302PubMedCentralCrossRefPubMed Allen KD, Chen JC, Callahan LF, Golightly YM, Helmick CG, Renner JB, Jordan JM: Associations of occupational tasks with knee and hip osteoarthritis: the Johnston County Osteoarthritis Project. J Rheumatol 2010, 37: 842–850. 10.3899/jrheum.090302PubMedCentralCrossRefPubMed
44.
go back to reference McWilliams DF, Leeb BF, Muthuri SG, Doherty M, Zhang W: Occupational risk factors for osteoarthritis of the knee: a meta-analysis. Osteoarthr Cartil 2011, 19: 829–839. 10.1016/j.joca.2011.02.016CrossRefPubMed McWilliams DF, Leeb BF, Muthuri SG, Doherty M, Zhang W: Occupational risk factors for osteoarthritis of the knee: a meta-analysis. Osteoarthr Cartil 2011, 19: 829–839. 10.1016/j.joca.2011.02.016CrossRefPubMed
45.
go back to reference Sayre EC, Li LC, Kopec JA, Esdaile JM, Bar S, Cibere J: The effect of disease site (knee, hip, hand, foot, lower back or neck) on employment reduction due to osteoarthritis. PLoS One 2010, 5: e10470. 10.1371/journal.pone.0010470PubMedCentralCrossRefPubMed Sayre EC, Li LC, Kopec JA, Esdaile JM, Bar S, Cibere J: The effect of disease site (knee, hip, hand, foot, lower back or neck) on employment reduction due to osteoarthritis. PLoS One 2010, 5: e10470. 10.1371/journal.pone.0010470PubMedCentralCrossRefPubMed
Metadata
Title
Impact of self-rated osteoarthritis severity in an employed population: Cross-sectional analysis of data from the national health and wellness survey
Authors
Marco daCosta DiBonaventura
Shaloo Gupta
Margaret McDonald
Alesia Sadosky
Dan Pettitt
Stuart Silverman
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2012
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-10-30

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