Disability-adjusted life expectancy lost due to pain severity and usual analgesic treatment among older adults with osteoarthritis in Spain

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Abstract
Background Osteoarthritis (OA) is a seriously debilitating disease, which prevalence is growing in aging population becoming a substantial burden (BoD) to society. Aim To assess disability-adjusted life expectancy (DALE) lost by pain severity and usual analgesic treatment among OA adults 65 + year in Spain. Methods The National Health Survey, a large, nationally representative, cross-sectional general health survey administered to 23,089 individuals was the data source. Data on subjects of 65 + years with a self-reported physician diagnosis of OA were analysed. Records were cross-classified by pain severity (no pain/mild pain, moderate pain and severe pain) and use of usual analgesics. DALE lost was used as a summary measure of BoD and expressed as both number of years of healthy life-expectancy lost due to disability and percentage of life-expectancy lost. Results 3389 records were analysed [women 73.3%; age 77.4 (SD 7.5) years]. Older OA patients showed a mean (95% CI) DALE loss of 3.5 (3.3–3.7) years, that represented on average a loss of 35.6% (33.8–37.4) as a percentage of life expectancy. Higher pain severity and analgesic treatment was statistically linked to more years of DALE lost; from 2.8 (2.3–3.2), in no/mild, to 9.0 (8.6–9.4) years in severe pain, and from 32.2% (27.5–36.9) to 90.9% (86.5–95.3) of life expectancy, respectively. Discussion In Spain, older adults with moderate to severe OA pain receiving usual analgesics showed a substantial BoD in terms of years of DALE lost and percentage of life expectancy lost. Conclusions Patients with treated moderate to severe pain showed a more significant burden in term of DALE lost despite analgesic treatment, which apparently fails to meet pain management needs.

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