saeideh dahaghin md, phd. osteoarthritis a chronic disease of joints no cure available pain is...
TRANSCRIPT
Saeideh Dahaghin MD, PhD
The effect of pain-killers on quality of life in Osteoarthritis patients
Osteoarthritis A chronic disease of joints
No cure available
pain is the main symptom of osteoarthritis
The most common reason of disability
To increase the quality of life in osteoarthritis pain-killers are the first choice
Surgery is the next available treatment
Generalised OA, pain-killers
Data on medication use in POHEM-OA
British Colombia Linked Health Data base (2003-2004)
probability of medication use in OA patient which was varied base on duration of OA and level of pain
Four type of pain-killers was used by OA patients;
AcetaminophenNSAIDsCoxibsOpioid
POHEM-OA represent the side effects of pain-killers in five categories : Gastro intestinal, Cardio vascular disease, Stroke, dyspepsia, other generic side effects
Health Related Quality of Life (HRQL)
Health utility index mark 3 (HUI 3) is an index of health related quality of life used in POHEM OA.
HUI is based on eight attributes: Vision, hearing, speech, ambulation, dexterity, emotional function,
cognitive function and pain.
Evaluated Scenarios
Base scenarioExtreme hypothetical scenariosScenario 0- no medication used by any OA patients Scenario 1- all OA population used all possible medication (Acetaminophen, NSAIDs, Coxibs, Opioid).
Scenarios based on HUI level 1- 100% medication given to people with HUI 0.85 and lower, no medication to HUI above 0.852- 100% medication given to people with HUI 0.95 and lower, no medication to HUI above 0.95
Scenarios based on certain increase of basic medication use in OA patientsBase scenario : medication use according to data derived from 25%, 50%, 75% or 100% increase in base scenario of medication use
Scenario side effect 0 or side effect 10
female male total 0.000
0.100
0.200
0.300
0.400
0.500
0.600
0.700
0.800
0.900
1.000
Basemed0 med1
Series10.694
0.699
0.704
0.709
0.714
Comparison of various level of pain-killers' use
Base 25% increase med 50% increase med 75% increase med 100% increase med
Base med 1 med1 in HUI<0.85 med1 in HUI<0.950.670
0.680
0.690
0.700
0.710
0.720
0.730
0.740
0.750
0.760
Comparison of pain-killers use with two level of HUI
Base side eff0 side eff100.686
0.688
0.690
0.692
0.694
0.696
0.698
0.700
Base Acet 1 NSAID1 Coxib1 Opioid10.690
0.695
0.700
0.705
0.710
0.715
The pure benefit of pain-killers on HUI or benefit plus side effects
side eff base side eff0
The effect of pain-killers on HUI is different in older age
Older people after 60 years old suffers more often from side effects
We would like to study the balance of side effect and benefit on HUI in people older than 60 years old.
To study the effect of side effect in various age group we did not have pohem-OA ready
Change the parameter of the probability of getting side effect of medication for various age group
HUI and HALE for various age group
Behnam version of POHEM ..