Chronic Low Back Pain with and without Concomitant Osteoarthritis: A Retrospective, Longitudinal Cohort Study of Patients in England.

Despite the high prevalence of chronic low back pain (CLBP) and osteoarthritis (OA), few estimates of the economic cost of these conditions in England have been published. The aim of the present analysis was to characterise the economic burden of moderate-to-severe pain associated with CLBP + OA and CLBP alone compared with general population-matched controls without CLBP or OA. The primary objective was to describe the total healthcare resource use (HCRU) and direct healthcare costs associated with the target patient populations. Secondary objectives were to describe treatment patterns and surgical procedures. This was a retrospective, observational cohort study of patients receiving healthcare indicative of moderate-to-severe chronic pain associated with CLBP, with or without OA. We used linked longitudinal data from the Clinical Practice Research Datalink GOLD and Hospital Episode Statistics (HES). Patients (cases) were matched 1 : 1 with controls on age, sex, comorbidity burden, GP practice, and HES data availability. The CLBP-alone cohort comprised 13 554 cases with CLBP and 13 554 matched controls; the CLBP + OA cohort comprised 7803 cases with both OA and CLBP and 7803 matched controls. Across all follow-up periods, patients with CLBP alone and those with CLBP + OA had significantly more GP consultations, outpatient attendances, emergency department visits, and inpatient stays than controls (all Moderate-to-severe chronic pain associated with CLBP-with or without OA-has a substantial impact on patients and healthcare providers, leading to higher HCRU and costs versus controls among people with CLBP alone or together with OA.

Informations de copyright

Copyright © 2023 Greg Coates et al.

Déclaration de conflit d'intérêts

GC and PC are employees of Pfizer UK. CL was an employee of Pfizer UK at the time of the work and is now employed by Pfizer Aus. HS was an employee of Pfizer UK during the conduct of the work. RW and TT are employees of Adelphi Real World, which was contracted by Pfizer UK to conduct this study. RDK declares a personal financial interest in his employment by the University of Nottingham, which receives funding for his salary in part from the Primary Integrated Community Solutions Ltd. In the past 36 months, RDK declares the following nonpersonal financial interests: consultancy through his employment with the University of Nottingham to Pfizer Ltd. and Mibe Ltd. AJD declares a personal financial interest in his employment with York Medical Group (YMG), and over the past 36 months with NHS111 and RCP (London), from whom he receives payment for his work as a part-time salaried GP with YMG, and over the past 36 months as a GP on the NHS111 COVID-19 Response and the NICE Gout Committee, respectively, and in his ownership and directorship of AD Outcomes Ltd. In the past 36 months, AJD declares the following personal financial interests through medical and health economics consultancy work for AD Outcomes Ltd. for: Emotive (Agency) Ltd., Grunenthal (UK), Grunenthal (GmbH), Pfizer (UK), Pharmacy Magazine, Spink Health, Tilray (Portugal), and RCGP, as a racecourse doctor for various racecourses (Croft, Doncaster, Market Rasen, Newcastle, Pontefract, Redcar, Southwell, and Thirsk), and as a locum GP with out-of-hours, NHS111 and urgent care work for Vocare part of Totally Plc. AJD has a nonpersonal financial interest in his roles as a Trustee of the Primary Care Rheumatology and Musculoskeletal Medicine (PCRMM) Society (Trustee from 2017 to 2020) and as Trustee of the UK Gout Society (ongoing). The PCRMM Society has received funding from multiple companies for its annual conference including from Pfizer (UK) in 2020. AJD's work as a Trustee of the PCRMM Society and the UK Gout Society and as GP Clinical Lead for the North of England Low Back Pain Group are voluntary and unpaid; DAW declares a personal financial interest in his employment by the University of Nottingham, which receives funding for his salary from the UK Government, Sherwood Forest Hospitals NHS Foundation Trust, and UKRI. He is Director of the UKRI/Versus Arthritis Advanced Pain Discovery Platform (personal pecuniary: paid by the University of Nottingham as part of job plan, funded by UKRI), Honorary Consultant Rheumatologist at Sherwood Forest Hospitals NHS Foundation Trust (personal pecuniary; paid by the University of Nottingham as part of job plan, funded by Sherwood Forest Hospitals), and Professor of Rheumatology, University of Nottingham (personal pecuniary; paid by the University of Nottingham). In the past 36 months, DAW declares the following nonpersonal financial interests: research support to the University of Nottingham from Versus Arthritis and National Institute for Health and care Research; grants from Pfizer Ltd., Eli Lilly, and UCB Pharma; consultancy through his employment with the University of Nottingham to Pfizer Ltd., Eli Lilly, AbbVie Ltd., AKL R&D, Galapagos, Reckitt Benckiser Health Ltd., and GlaxoSmithKline Plc, and responsibilities for investigator-led grants outside the work in this presentation held by the University of Nottingham from Pfizer Ltd., Lilly Ltd. and UCB Pharma, and research grants from Versus Arthritis; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events (to University of Nottingham) from Pfizer Ltd. and AbbVie. The authors declare that they have no conflicts of interest.