Objectives: Osteoarthritis (OA) and chronic low back pain (CLBP) are common musculoskeletal disorders with substantial patient and societal burden. Nordic administrative registers offer a unique opportunity to study the impact of these conditions in the real-world setting. The Burden of Disease and Management of Osteoarthritis and Chronic Low Back Pain: Health Care Utilization and Sick Leave in Sweden, Norway, Finland and Denmark (BISCUITS) study was designed to study disease prevalence and the societal and economic burden in broad OA and CLBP populations. Methods: Patients in Sweden, Norway, Finland and Denmark with diagnoses of OA or CLBP (low back pain record plus ≥2 pain relief prescriptions to indicate chronicity) were identified in specialty care, in primary care (Sweden and Finland) and in a quality-of-care register (Sweden). Matched controls were identified for the specialty care cohort. Longitudinal data were extracted on prevalence, treatment patterns, patient-reported outcomes, social and economic burden. Results: Almost 1.4 million patients with OA and 0.4 million with CLBP were identified in specialty care, corresponding to a prevalence in the Nordic countries of 6.3 and 1.9%, respectively. The prevalence increased to 11-14% for OA and almost 6% for CLBP when adding patients identified in primary care. OA patients had a higher Elixhauser comorbidity index (0.66 vs. 0.46) and were using opioids (44.7 vs. 10.2%) or long-term nonsteroidal anti-inflammatory drug (NSAIDs) (20.9 vs. 4.5%) more than four times as often as compared to controls. The differences were even larger for CLBP patients compared to their controls (comorbidity index 0.89 vs. 0.39, opioid use 77.7 vs. 9.4%, and long-term NSAID use 37.2 vs. 4.8%). Conclusions: The BISCUITS study offers an unprecedented, longitudinal healthcare data source to quantify the real-world burden of more than 1.8 million patients with OA or CLBP across four countries. In subsequent papers we aim to explore among others additional outcomes and subgroups of patients, primarily those patients who may benefit most from better healthcare management.
Bibliografisk noteFunding Information:
Research funding: This study was sponsored by Pfizer and Eli Lilly & Company.
Conflict of interests: Sara Hallberg, Emilie Toresson Grip and Anders Gustavsson are employees at Quantify Research, who were paid consultants to Pfizer and Eli Lilly & Company in connection with this research and the development of this manuscript. Rebecca Robinson is an employee and stockholder of Eli Lilly. Patricia Schepman and Christoph Varenhorst are employees at Pfizer with stock and/or stock options. Jaro Karppinen, Berit Schiøttz-Christensen and Audun Stubhaug were paid contractors to Pfizer and Eli Lilly & Company in connection with this study. Ola Rolfson is an employee of the Swedish Arthroplasty Register which received funding from Pfizer and Eli Lilly and Company to conduct this study. Marcelo Rivano Fischer and Björn Gerdle are employees of the Swedish Quality Registry for Pain Rehabilitation which received funding from Pfizer and Eli Lilly and Company to conduct this study. Medical writing support was provided by Sara Hallberg and Anders Gustafsson at Quantify Research and was funded by Pfizer and Eli Lilly & Company.
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