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The effect of pain-killers on quality of life in Osteoarthritis patients. Saeideh Dahaghin MD, PhD. Osteoarthritis A chronic disease of joints No cure available pain is the main symptom of osteoarthritis The most common reason of disability
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The effect of pain-killers on quality of life in Osteoarthritis patients Saeideh Dahaghin MD, PhD
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; Acetaminophen NSAIDs Coxibs Opioid 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 scenario Extreme hypothetical scenarios Scenario 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 0.85 2- 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 patients Base 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
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 . .