Predictors of pain interference and potential gain from intervention in community dwelling adults with joint pain: A prospective cohort study.

INTRODUCTION There is little research on identifying modifiable risk factors that predict future interference of pain with daily activity in people with joint pain, and the estimation of the corresponding population attributable risk (PAR). The present study therefore investigated modifiable predictors of pain interference and estimated maximum potential gain from intervention in adults with joint pain. METHODS A population-based cohort aged ≥50 years was recruited from eight general practices in North Staffordshire, UK. Participants (n = 1878) had joint pain at baseline lasting ≥3 months and indicated no pain interference. Adjusted associations of self-reported, potentially modifiable prognostic factors (body mass index, anxiety/depressive symptoms, widespread pain, inadequate joint pain control, physical inactivity, sleep problems, smoking and alcohol intake) with onset of pain interference 3 years later were estimated via Poisson regression, and corresponding PAR estimates were obtained. RESULTS Inadequate joint-specific pain control, insomnia and infrequent walking were found to be independently significantly associated with the onset of pain interference after 3 years, with associated PARs of 6.3% (95% confidence interval -0.3, 12.4), 7.6% (-0.4, 15.0) and 8.0% (0.1, 15.2), respectively, with only the PAR for infrequent walking deemed statistically significant. The PAR associated with insomnia, infrequent walking and inadequate control of joint pain simultaneously was 20.3% (8.6, 30.4). CONCLUSIONS There is potential to reduce moderately the onset of pain interference from joint pain in the over-50s if clinical and public health interventions targeted pain management and insomnia, and promoted an active lifestyle. However, most of the onset of significant pain interference in the over-50s, would not be prevented, even assuming that these factors could be eliminated.

[1]  P. Devita,et al.  Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better? , 2018, Arthritis care & research.

[2]  T. Fu,et al.  Effects of psychological interventions for patients with osteoarthritis: a systematic review and meta-analysis , 2018, Psychology, health & medicine.

[3]  R. Hinman,et al.  Interventions to increase adherence to therapeutic exercise in older adults with low back pain and/or hip/knee osteoarthritis: a systematic review and meta-analysis , 2017, British Journal of Sports Medicine.

[4]  Xiaoning He,et al.  Economic and Humanistic Burden of Osteoarthritis: A Systematic Review of Large Sample Studies , 2016, PharmacoEconomics.

[5]  D. Marshall,et al.  Risk of work loss due to illness or disability in patients with osteoarthritis: a population-based cohort study. , 2016, Rheumatology.

[6]  W. Lems,et al.  Course and predictors of pain and physical functioning in patients with hip osteoarthritis: Systematic review and meta-analysis. , 2016, Journal of rehabilitation medicine.

[7]  Ewa M. Roos,et al.  Strategies for the prevention of knee osteoarthritis , 2016, Nature Reviews Rheumatology.

[8]  J. Protheroe,et al.  Development of hand phenotypes and changes in hand pain and problems over time in older people , 2015, Pain.

[9]  F. Blyth,et al.  Chronic Disabling Pain: A Significant Public Health Problem. , 2015, American journal of preventive medicine.

[10]  O. Uthman,et al.  Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis , 2014, British Journal of Sports Medicine.

[11]  H. Menz,et al.  The population prevalence of symptomatic radiographic foot osteoarthritis in community-dwelling older adults: cross-sectional findings from the Clinical Assessment Study of the Foot , 2013, Annals of the rheumatic diseases.

[12]  P. Croft,et al.  The role of sleep problems in the development of depression in those with persistent pain: a prospective cohort study. , 2013, Sleep.

[13]  P. Croft,et al.  Defining and mapping the person with osteoarthritis for population studies and public health , 2013, Rheumatology.

[14]  A. Hofman,et al.  Prediction model for knee osteoarthritis incidence, including clinical, genetic and biochemical risk factors , 2013, Annals of the rheumatic diseases.

[15]  H. French,et al.  Predictors of Short-Term Outcome to Exercise and Manual Therapy for People With Hip Osteoarthritis , 2013, Physical Therapy.

[16]  W. Lems,et al.  Three trajectories of activity limitations in early symptomatic knee osteoarthritis: a 5-year follow-up study , 2013, Annals of the rheumatic diseases.

[17]  M. Englund,et al.  International comparisons of the consultation prevalence of musculoskeletal conditions using population-based healthcare data from England and Sweden , 2013, Annals of the rheumatic diseases.

[18]  B. Koes,et al.  Defining discriminative pain trajectories in hip osteoarthritis over a 2-year time period , 2012, Annals of the rheumatic diseases.

[19]  D. A. van der Windt,et al.  Factors associated with the severity and progression of self-reported hand pain and functional difficulty in community-dwelling older adults: a systematic review. , 2012, Musculoskeletal care.

[20]  P. Slagboom,et al.  Association between Several Clinical and Radiological Determinants with Long-Term Clinical Progression and Good Prognosis of Lower Limb Osteoarthritis , 2011, PloS one.

[21]  G. Baxter,et al.  Patient characteristics that predict progression of knee osteoarthritis: A systematic review of prognostic studies , 2011, Arthritis care & research.

[22]  M. Doherty,et al.  What if we prevent obesity? Risk reduction in knee osteoarthritis estimated through a meta‐analysis of observational studies , 2011, Arthritis care & research.

[23]  F. Berenbaum,et al.  Osteoarthritis: an update with relevance for clinical practice , 2011, The Lancet.

[24]  Michael Doherty,et al.  Nottingham knee osteoarthritis risk prediction models , 2011, Annals of the rheumatic diseases.

[25]  C. Cook,et al.  Predictors of Response to Physical Therapy Intervention in Patients With Primary Hip Osteoarthritis , 2011, Physical Therapy.

[26]  Patrick Royston,et al.  Multiple imputation using chained equations: Issues and guidance for practice , 2011, Statistics in medicine.

[27]  Toshihiro Tanaka,et al.  Prediction model for knee osteoarthritis based on genetic and clinical information , 2010, Arthritis Research & Therapy.

[28]  M. Blagojevic,et al.  Predictors of onset and progression of knee pain in adults living in the community. A prospective study. , 2007, Rheumatology.

[29]  P. Croft,et al.  Epidemiology of insomnia: a longitudinal study in a UK population. , 2007, Sleep.

[30]  C. Jinks,et al.  Disabling knee pain – another consequence of obesity: Results from a prospective cohort study , 2006, BMC public health.

[31]  A. Tennant,et al.  Impact of multiple joint problems on daily living tasks in people in the community over age fifty-five. , 2006, Arthritis & Rheumatism.

[32]  P. Croft,et al.  Multiple joint pain and lower extremity disability in middle and old age , 2006, Disability and rehabilitation.

[33]  F. Birrell,et al.  Patterns of joint pain: lessons from epidemiology. , 2004, Rheumatology.

[34]  G. Zou,et al.  A modified poisson regression approach to prospective studies with binary data. , 2004, American journal of epidemiology.

[35]  P. Croft,et al.  The North Staffordshire Osteoarthritis Project – NorStOP: Prospective, 3-year study of the epidemiology and management of clinical osteoarthritis in a general population of older adults , 2004, BMC musculoskeletal disorders.

[36]  R. Snaith,et al.  The Hospital Anxiety And Depression Scale , 2003, Health and quality of life outcomes.

[37]  R. Buchbinder,et al.  Dimensionality and clinical importance of pain and disability in hand osteoarthritis: Development of the Australian/Canadian (AUSCAN) Osteoarthritis Hand Index. , 2002, Osteoarthritis and cartilage.

[38]  A. Silman,et al.  Development and validation of a questionnaire to assess disabling foot pain , 2000, Pain.

[39]  J. Ware,et al.  A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. , 1996, Medical care.

[40]  S Greenland,et al.  Maximum likelihood estimation of the attributable fraction from logistic models. , 1993, Biometrics.

[41]  P. Tugwell,et al.  The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. , 1990, Arthritis and rheumatism.

[42]  M. Bergner,et al.  The Sickness Impact Profile: Development and Final Revision of a Health Status Measure , 1981, Medical care.

[43]  L. Berkman,et al.  Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. , 1979, American journal of epidemiology.

[44]  J. Carter,et al.  Obesity and the role of bariatric surgery in the surgical management of osteoarthritis of the hip and knee: a review of the literature. , 2017, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.