Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale.

methods: A prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of endometriosis and with at least one centre-specific contact related to endometriosis-associated symptoms in 2008. The main outcome measures were health care costs, costs of productivity loss, total costs and quality-adjusted life years. Predictors of costs were identified using regression analysis. results: Data analysis of 909 women demonstrated that the average annual total cost per woman was E9579 (95% confidence interval E8559–E10 599). Costs of productivity loss of E6298 per woman were double the health care costs of E3113 per woman. Health care costs were mainly due to surgery (29%), monitoring tests (19%) and hospitalization (18%) and physician visits (16%). Endometriosis-associated symptoms generated 0.809 quality-adjusted life years per woman. Decreased quality of life was the most important predictor of direct health care and total costs. Costs were greater with increasing severity of endometriosis, presence of pelvic pain, presence of infertility and a higher number of years since diagnosis. conclusions: Our study invited women to report resource use based on endometriosis-associated symptoms only, rather than drawing on a control population of women without endometriosis. Our study showed that the economic burden associated with endometriosis treated in referral centres is high and is similar to other chronic diseases (diabetes, Crohn’s disease, rheumatoid arthritis). It arises predominantly from productivity loss, and is predicted by decreased quality of life.

http://www.royanaward.com/files13/Hum%20Reprod%202012%20in%20press.pdf

The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres

Musculoskeletal disorders (MSDs) are the leading cause of work disability, sickness absence from work, ‘presenteeism’ and loss of productivity across all the European Union (EU) member states. It is estimated that the total cost of lost productivity attributable to MSDs among people of working age in the EU could be as high as 2% of gross domestic product (GDP). This paper examines the available evidence on the economic burden of MSDs on work across Europe and highlights areas of policy, clinical and employment practice which might improve work outcomes for individuals and families and reduce the economic and social costs of MSDs.

Economic impact of musculoskeletal disorders (MSDs) on work in Europe

ESH/ESC guidelines for the management of arterial hypertension: how to implement in daily clinical practice

Objective The objective of the MAPPING study was to estimate the prevalence of musculoskeletal conditions in an Italian population sample. Methods Questionnaires were sent to a random sample of 3664 individuals aged 18 years and over, stratified for age and gender, selected from the practice lists of 16 general practices. Trained rheumatologists carried out structured visits in which subjects were asked about musculoskeletal symptoms and socio-demographic characteristics, and underwent a standardized physical examination. Cases were defined by previously validated criteria. Results A total of 2155 subjects participated in the study (response rate 58.8%). The overall prevalence of musculoskeletal conditions in the general adult population was 26.7% (95% C1 25.4-28.5), being significantly higher among women than men (p < 0.0001). Disease prevalence increased significantly with age (p < 0.0001). The most common disease group was symptomatic peripheral osteoarthritis (SPOA), with a prevalence of 8.95% (95% CI 6.81-10.7), followed by soft tissue disorders - STD (8.81%; 95% CI 7.16-10.29), low back pain - LBP (5.91%; 95% CI 4.89-6.89), and inflammatory rheumatic disease -IRD (3.06%; 95% CI 2.38-3.93). The estimated rates of disease prevalence were as follows: rheumatoid arthritis: 0.46% (95% CI 0.33-0.59); psoriatic arthritis: 0.42% (95% CI 0.31-0.61); ankylosing spondylitis: 0.37% (95% CI 0.23-0.49); polymyalgia rheumatica: 0.37% (95% CI 0.29-0.44); undifferentiated connective tissue disease: 0.14% (95% CI 0.09-0.21); crystal arthropathies, including gout 0.46% (95% CI 0.34-0.57) and chondrocalcinosis: 0.42% (95% CI 0.33-0.58); symptomatic knee osteoarthritis (OA): 5.39% (95% CI 3.41-7.99); hip-OA: 1.61% (95% CI 1.39-1.87); hand-OA: 1.95 (95% CI 1.22-2.48); fibromyalgia: 2.22% (95% CI 1.36-3.19); shoulder fendinitis/adhesive capsulifis: 3.06% (95% CI 2.11-4.09); carpal tunnel syndrome: 1.90% (95% CI 1.06-2.29), localized regional pain syndromes of the neck: 0.88% (95% CI 0.56-1.29), and lateral epicondylitis 0.74% (95% CI 0.47-1.33). Conclusions The MAPPING study indicates that musculoskeletal conditions are common in the general adult population of Italy. These data are useful in planning the provision of healthcare.

Prevalence of musculoskeletal conditions in an italian population sample: results of a regional community-based study. i. the mapping study

Objective Rheumatoid arthritis (RA) is a chronic and disabling, disease frequently leading to physical and psychological dependence, with considerable economic consequences The aim of our study was to perform a cost-of-illness analysis for RA according to the four different levels of functional RA severity Methods Direct costs (hospitalisations, treatments, diagnostics and the non-medical costs), indirect costs (productivity losses and informal care), and intangible costs (deterioration in the quality of life of patients, their families and friends assessed by the Medical Outcome Survey Short Form and the Stanford Health Assessment Questionnaire) were measured in 200 RA patients Results The social costs - direct plus indirect costs - increased as RA worsened The direct costs increase very significantly (p < 00005) among the four functional classes (respectively Euro 16434 - 29102 - 42365 - 56968), likewise the indirect costs (respectively Euro 27049 - 95664 - 121831 - 172492) Moreover social costs, analysed independently from the functional classes, are significantly higher in patients with other concomitant diseases As far as the intangible costs are concerned, for all the areas explored by the scales used, the high impact of RA on the quality of life of RA patients was markedly evident Female gender and co-morbidity are associated with higher costs Conclusions In Italy, the indirect costs account for the highest cost for management of RA patients Considering that costs increase with RA progression, the patients who show a rapid evolution of the functional damages should be identified early based on risk indicators

/pdf/a-multicenter-cost-of-illness-study-on-rheumatoid-arthritis-36l8gd3a6c.pdf

A multicenter cost-of-illness study on rheumatoid arthritis in Italy

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A multicenter cost-of-illness study on rheumatoid arthritis in Italy