Health status and patient-reported osteoarthritis severity in clinical practice

Aim: To determine how patient-reported osteoarthritis (OA) severity relates to patient-reported health status and physician-rated outcomes in clinical practice. Methods: Data were derived from the U.S.-based sample of the 2008 Adelphi Disease Specific Programme for OA (OA DSP VII). Patients self-rated their OA severity as "mild," "moderate," and "severe." The association of OA severity with patientreported health status (EQ-5D) and physician-completed health assessments was evaluated using regression models for quantitative variables (adjusted for age and gender, with patient-reported OA severity as the predictor) and chi-square tests for qualitative variables. Results: Of 998 subjects in the OA DSP VII, 714 (71.5%) agreed to participate. The population was predominantly female (61.7%) with a mean age of 63.8 years, and a mean of 5.6 years since OA diagnosis. Patient-reported OA severity was significantly associated (p<0.01) with health status on all 5 EQ-5D dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). The EQ-5D preferenceweighted index, based on U.S. preference values, decreased with increasing OA severity (mild, 0.85; moderate, 0.73; severe, 0.52; all pairwise comparisons p<0.001). Patientreported OA severity was associated with increased levels of analgesia requirements (p<0.05) and with the presence of cardiovascular (p<0.001) and gastric conditions (p<0.001). Although there was a significant association between patient-and physician- reported OA severity (p<0.05), physicians generally overrated mild OA and underrated severe OA relative to patients. Conclusions: In the clinical setting, patient-reported OA severity offers a rapid and useful assessment that maps to a key measure of health status, suggesting applicability to guiding patient management strategies.