Health-related quality of-life and costs in patients with osteoarthritis on waiting list for total knee replacement

Objectives: To determine: (1) health-related quality of life (HRQL) in patients with severe osteoarthritis (OA) on a waiting list (WL) for total knee replacement (TKR) and to compare it with general Spanish reference population values (RPVs); (2) the influence of sociodemographic and clinical variables on HRQL dimensions and (3) the use and cost of resources related to knee OA. Methods: Cross-sectional study. HRQL was measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Medical Outcomes Study 36 Item Short Form Health Survey (SF-36) questionnaires. Sociodemographic and disease characteristics, body mass index, pharmacological treatment and the cost and use of economic resources related to knee OA during the 6-months previous to baseline were recorded. Relationships were analyzed using linear regression models. Results: One hundred consecutive outpatients (71 female, mean age 71 +/- 6.89 years, mean disease duration 11.84 +/- 10.52 years) were included. Patients showed worse HRQL measured by SF-36 than the reference population, mainly in physical function, physical role and bodily pain dimensions (P < 0.05). A low number of visits to physicians were recorded (mean 0.62 +/- 1.-04). Total mean direct medical costs were 200.24 (sic) (95%CI 167.08-233.40) and total mean direct non-medical costs were 1234.87 (sic) (95%CI 812.74-1657.00). Conclusions: The HRQL of patients on a WL is worse than that of the reference population. The main costs of these patients were on non-medical resources, mainly due to functional limitations and loss of autonomy. The results suggest little compliance with knee OA management guidelines. (C) 2006 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.