RISK INDICATORS FOR SELF-REPORTED JOINT PAIN AND MOTION LIMITATION OUTCOMES IN HEMOPHILIA PATIENTS-THE HEMOPHILIA COST AND IMPACT OF DISEASE STUDY-PART V
Author(s)
Joanne Wu, MS, Project Manager1, Denise Globe, PhD, Director2, Brenda Riske, MS, MBA, MPA, HUGS Site PI3, Joan Wasserman, RN, MBA, HUGS Site Consultant4, Kathleen A Johnson, PharmD, MPH, Associate Professor11University of Southern California, Los Angeles, CA, USA; 2 Amgen, Thousand Oaks, CA, USA; 3 University of Colorado Health Sciences Center, Aurora, CO, USA; 4 University of Texas at Houston, Houston, TX, USA
OBJECTIVES: To assess risk indicators for self-reported joint pain and motion limitation outcomes in hemophilia patients. METHODS: The Hemophilia Utilization Group Study (HUGS) examines prospectively the cost and burden of hemophilia, including arthropathy, quality of life, and economic impact in patients aged 2 to 65. Parents/patients completed a standardized interview, including factor use patterns and assessment of joint pain and motion limitation. Clinical chart reviews were performed to identify the presence of inhibitor antibodies and hemophilia severity. Logistic regression was used to evaluate the association between the factors from the Health Behavioral Model (predisposing, enabling, need, and health behavior) and the likelihood of joint pain or motion limitation. RESULTS: Of the 128 patients with complete outcome data, 70(55%) were adults, 32(25%) reported joint pain most or all the time, 49(39%) reported severe motion limitation in at least one joint. Mean age was 23.8 (16.2) years. Risk indicators associated with joint pain were: 1) predisposing: increasing age (OR=1.1; 95% CI=1.03, 1.1); parent/patient not married/without partner (OR=5.7; 1.8, 18.3), and 2) enabling: increasing number of problems getting care at the hemophilia treatment center (OR=1.9; 1.03, 3.6). No association was found in need (ever had inhibitor) and health behaviors (use of factor). Risk indicators associated with severe motion limitation were: 1) predisposing: increasing age (OR=1.1; 95% CI=1.07, 1.2); parent/patient not married/without partner (OR=3.9; 1.3, 12.2); severe hemophilia (OR=21.0; 2.8, 158.9). CONCLUSION: Increasing age, lack of a support system and more severe hemophilia are useful characteristics for clinicians to identify patients at greater risk for joint pain and limitation. Early identification of these factors, which are a major source of disability, may be helpful in avoiding decreased health status and increased medical costs. Addressing barriers to receipt of care is of particular import for those most at risk.
Conference/Value in Health Info
2006-05, ISPOR 2006, Philadelphia, PA
Value in Health, Vol. 9, No.3 (May/June 2006)
Code
PR7
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Systemic Disorders/Conditions