OBJECTIVES: To characterize patients with hip/knee osteoarthritis (OA) and chronic lower back pain (CLBP), describe the epidemiology of these conditions and evaluate treatment patterns in routine care within these populations based on German real-world data.

METHODS: Source of data was the InGef Research Database comprising data of more than four million people who are enrolled in German statutory health insurances. Analyses were based on the year 2016. Identification of cases with hip/knee OA and CLBP was based on inpatient and outpatient diagnoses. In patients with CLBP, a documented diagnosis was required for at least two consecutive quarters. Identified patients were assigned to the categories of the WHO levels, an escalation scheme for analgesics to achieve pain relief, according to their highest pain therapeutic intensity in 2016: Beyond WHO scheme (interventional therapy), WHO III (strong opioids), WHO II (weak opioids), WHO I (non-opioids).

RESULTS: Overall, 307,256 cases with hip/knee OA and 146,443 cases with CLBP were identified corresponding to a one-year prevalence of 11.4% (hip/knee OA) and 5.4% (CLBP) in the German population. At least one pain management intervention was recorded in 65.1% of hip/knee OA patients and 66.3% of CLBP patients. Within those treated, hip/knee OA patients most often received WHO I drugs as the highest therapeutic intensity (68.7%) followed by WHO II drugs (13.3%), beyond WHO interventions (10.1%) and WHO III drugs (7.8%). In treated CLBP patients, WHO I drugs also were the most frequently observed highest therapeutic intensity (73.6%) followed by WHO II drugs (16.1%), WHO III drugs (7.8%) and beyond WHO interventions (2.5%).

CONCLUSIONS: Prevalence of chronic pain conditions such as hip/knee OA and CLBP is high, particularly in elderly patients. Around one third of observed patients did not receive reimbursed pain interventions during the observation period. The management of patients with chronic pain conditions is heterogeneous.