Exploring How Pain Leads to Productivity Loss in Primary Care Consulters for Osteoarthritis: A Prospective Cohort Study

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Wilkie, Ross ; Hay, Elaine M. ; Croft, Peter ; Pransky, Glenn (2015)

OBJECTIVE: Osteoarthritis pain has become a leading cause of decreased productivity and work disability in older workers, a major concern in primary care. How osteoarthritis pain leads to decreased productivity at work is unclear; the aim of this study was to elucidate causal mechanisms and thus identify potential opportunities for intervention. METHODS: Population-based prospective cohort study of primary care consulters with osteoarthritis. Path analysis was used to test proposed mechanisms by examining the association between pain at baseline, and onset of work productivity loss at three years for mediation by physical limitation, depression, poor sleep and poor coping mechanisms. RESULTS: High pain intensity was associated with onset of work productivity loss (Adjusted Odds Ratio 2.5; 95%CI 1.3, 4.8). About half of the effect of pain on work productivity was a direct effect, and half was mediated by the impact of pain on physical function. Depression, poor sleep quality and poor coping did not mediate the association between high pain intensity and onset of work productivity loss. CONCLUSIONS: As pain is a major cause of work productivity loss, results suggest that decreasing pain should be a major focus. However, successfully improving function may have an indirect effect by decreasing the impact of pain on work productivity, especially important as significant pain reduction is often difficult to achieve. Although depression, sleep problems, and coping strategies may be directly related to work productivity loss, addressing these issues may not have much effect on the significant impact of pain on work productivity.
  • References (38)
    38 references, page 1 of 4

    1. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859):2197-223. doi: 10.1016/S0140-6736(12) 61689-4 PMID: 23245608

    2. Mody GM, Brooks PM. Improving musculoskeletal health: global issues. Best Pract Res Clin Rheumatol 2012; 26(2):237-49. doi: 10.1016/j.berh.2012.03.002 PMID: 22794096

    3. Jordan K, Clarke AM, Symmons DP, Fleming D, Porcheret M, Kadam UT et al. Measuring disease prevalence: a comparison of musculoskeletal disease using four general practice consultation databases. Br J Gen Pract 2007; 57:7-14. PMID: 17244418

    4. Dibonaventura MD, Gupta S, McDonald M, Sadosky A, Pettitt D, Silverman S. Impact of self-rated osteoarthritis severity in an employed population: cross-sectional analysis of data from the national health and wellness survey. Health Qual Life Outcomes 2012;15; 10:30. doi: 10.1186/1477-7525-10-30 PMID: 22420468

    5. Wilkie R, Phillipson C, Hay E, Pransky G. Frequency and predictors of premature work loss in primary care consulters for osteoarthritis: prospective cohort study. Rheumatology 2014; 53(3):459-64. doi: 10. 1093/rheumatology/ket336 PMID: 24136068

    6. Stewart WF, Ricci JA, Chee E, Morganstein D. Lost productive work time costs from health conditions in the United States: results from the American Productivity Audit. J Occup Environ Med 2003; 45 (12):1234-46. PMID: 14665809

    7. Tang K, Escorpizo R, Beaton DE, Bombardier C, Lacaille D, Zhang W, et al. Measuring the impact of arthritis on worker productivity: Perspectives, methodologic issues, and contextual factors. Journal of Rheumatology 2011; 38: 1776-1790. doi: 10.3899/jrheum.110405 PMID: 21807801

    8. Bieleman HJ, Bierma-Zeinstra SM, Oosterveld FG, Reneman MF, Verhagen AP, Groothoff JW. The effect of osteoarthritis of the hip or knee on work participation. J Rheumatol 2011; 38(9):1835-43. doi: 10. 3899/jrheum.101210 PMID: 21677000

    9. Wilkie R, Blagojevic-Bucknall M, Jordan KP, Lacey R, McBeth J. Reasons why multimorbidity increases the risk of participation restriction in older adults with lower extremity osteoarthritis: a prospective cohort study in primary care. Arthritis Care Res 2013; 65(6):910-9. doi: 10.1002/acr.21918 PMID: 23225783

    10. Golightly YM, Allen KD, Stechuchak KM, Coffman CJ, Keefe FJ. Associations of Coping Strategies with Diary Based Pain Variables Among Caucasian and African American Patients with Osteoarthritis. Int J Behav Med 2015; 22(1):101-8. doi: 10.1007/s12529-013-9365-3 PMID: 24590828

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