Autor(es): Costa, Daniela ; Lopes, David G. ; Cruz, Eduardo B. ; Henriques, Ana R. ; Branco, Jaime ; Canhão, Helena ; Rodrigues, Ana M.
Data: 2023
Identificador Persistente: http://hdl.handle.net/10362/158497
Origem: Repositório Institucional da UNL
Assunto(s): Health-Related Quality of Life; Osteoarthritis; Physical Function; Prognosis; Trajectories; Public Health, Environmental and Occupational Health; SDG 3 - Good Health and Well-being
Funding Information: We thank Prof. Carla Nunes (NOVA National School of Public Health – Universidade NOVA de Lisboa) for the valuable insights and discussions in the conceptualization of this project. We thank the EpiDoc Unit and EpiReumaPt team for conceptualizing, planning, and implementing the main research project. We also acknowledge the support of CHRC (UIDP/04923/2020), granted by national funds through Fundação Ciência e Tecnologia, IP. Funding Information: This study received funding from an independent research grant (ID: 64165707) by Pfizer, and the first author received a grant from Fundação Ciência e Tecnologia, IP under the PhD grant SFRH/BD/148420/2019. The funders were not involved in study design; collection, analysis, or interpretation of data; or writing this article or the decision to submit it for publication. Funding Information: We thank Prof. Carla Nunes (NOVA National School of Public Health – Universidade NOVA de Lisboa) for the valuable insights and discussions in the conceptualization of this project. We thank the EpiDoc Unit and EpiReumaPt team for conceptualizing, planning, and implementing the main research project. We also acknowledge the support of CHRC (UIDP/04923/2020), granted by national funds through Fundação Ciência e Tecnologia, IP. Publisher Copyright: © 2023, The Author(s).
Objective: To identify long-term trajectories of physical function and health-related quality of life (HRQoL) among people with hip and/or knee osteoarthritis (HKOA) and the sociodemographic, lifestyle, and clinical factors associated with different trajectories. Methods: Participants with HKOA from the EpiDoC study, a 10-year follow-up (2011–2021) population-based cohort, were considered. Sociodemographic, lifestyle, and clinical variables were collected at baseline in a structured interview and clinical appointment. Physical function and HRQoL were evaluated with the Health Assessment Questionnaire (HAQ) and EuroQoL, respectively, at baseline and the three follow-ups. Group-based trajectory modeling identified physical function and HRQoL trajectories. Multinomial logistic regression analyzed the associations between the covariates of interest and trajectory assignment (p < 0.05). Results: We included 983 participants with HKOA. We identified three trajectories for each outcome: “consistently low disability” (32.0%), “slightly worsening moderate disability” (47.0%), and “consistently high disability” (21.0%) for physical function; “consistently high HRQoL” (18.3%), “consistently moderate HRQoL” (48.4%) and “consistently low HRQoL” (33.4%) for HRQoL. Age ≥ 75 years, female sex, multimorbidity, and high baseline clinical severity were associated with higher risk of assignment to poorer physical function and HRQoL trajectories. Participants with high education level and with regular physical activity had a lower risk of assignment to a poor trajectory. Unmanageable pain levels increased the risk of assignment to the “consistently moderate HRQoL” trajectory. Conclusion: Although the trajectories of physical function and HRQoL remained stable over 10 years, approximately 70% of people with HKOA maintained moderate or low physical function and HRQoL over this period. Modifiable risk factors like physical activity, multimorbidity and clinical severity were associated with poorer physical function and HRQoL trajectories. These risk factors may be considered in tailored healthcare interventions.
