The added burden of depression in patients with osteoarthritis in Japan
Received 3 October 2018
Accepted for publication 26 March 2019
Published 20 June 2019 Volume 2019:11 Pages 411—421
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 3
Editor who approved publication: Professor Dean Smith
Toshinaga Tsuji,1 Ken Nakata,2 Jeffrey Vietri,3 Dena H Jaffe4
1Medical Affairs Department, Shionogi & Co., Ltd, Osaka, Japan; 2Medicine for Sports and Performing Arts, Osaka University, Suita, Japan; 3Health Outcomes Practice, Health Division, Kantar, 4 Ariel Sharon Street, Horsham, PA, USA; 4Health Outcomes Practice, Health Division, Kantar, Tel Aviv, Israel
Objectives: In Japan, osteoarthritis (OA) is a leading source of pain and disability; depressive disorders may limit patients’ ability to cope with OA. This study examined the incremental effect of depression on the relationship between OA and health-related outcomes.
Methods: Data from the 2014 Japan National Health and Wellness Survey (N=30,000) were collected on demographics, OA characteristics, and health characteristics of patients with OA. Depression symptoms were measured, and outcomes included health-related quality of life (HRQoL), work productivity and activity impairment, and health care resource utilization. Generalized linear regression models controlling for confounders were used to predict health-related outcomes.
Results: Of 565 respondents with OA, 63 (11%) had symptoms of moderate or severe depression. In adjusted models, HRQoL remained lower among respondents with than without depression (p<0.001). Higher levels of presenteeism (mean±SE: 50%±9% vs 23%±2%) and activity impairment (mean±SE: 57%±7% vs 30%±1%) were observed for patients with than without depression (p<0.001); however, there were no differences for absenteeism (p=0.534). Patients with depression (vs no depression) reported more health care provider visits, emergency room visits, and hospitalizations (for all, p<0.001).
Conclusion: Depression heightens the health-related burden of OA. Greater attention to depression among patients with OA is warranted.
Keywords: depression, quality of life, Japan musculoskeletal diseases, osteoarthritis
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