Saeideh Dahaghin MD, PhD

The effect of pain-killers on quality of life in Osteoarthritis patients

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;

AcetaminophenNSAIDsCoxibsOpioid

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 scenarioExtreme hypothetical scenariosScenario 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 0.852- 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 patientsBase 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

female male total 0.000

0.100

0.200

0.300

0.400

0.500

0.600

0.700

0.800

0.900

1.000

Basemed0 med1

Series10.694

0.699

0.704

0.709

0.714

Comparison of various level of pain-killers' use

Base 25% increase med 50% increase med 75% increase med 100% increase med

Base med 1 med1 in HUI<0.85 med1 in HUI<0.950.670

0.680

0.690

0.700

0.710

0.720

0.730

0.740

0.750

0.760

Comparison of pain-killers use with two level of HUI

Base side eff0 side eff100.686

0.688

0.690

0.692

0.694

0.696

0.698

0.700

Base Acet 1 NSAID1 Coxib1 Opioid10.690

0.695

0.700

0.705

0.710

0.715

The pure benefit of pain-killers on HUI or benefit plus side effects

side eff base side eff0

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 ..