Health Related Quality of Life among Osteoarthritis Patients: A Comparison of Traditional Non-Steroidal Anti-Inflammatory Drugs and Selective COX-2 Inhibitors in the United Arab Emirates Using the SF-36

Mohammed Hassanein^*, Mohammed Shamssain, Nageeb Hassan

Clinical Pharmacy Department, College of Pharmacy and Health Science, Ajman University of Science and Technology, Ajman, United Arab Emirates.

DOI: 10.4236/pp.2015.64025                

Abstract

Objectives: Osteoarthritis (OA) has a dramatic impact on patients’ health related quality of life (HRQoL). Chronic use of analgesics and anti-inflammatory medications for pain management may improve symptoms but on long term may affect HRQoL negatively. The objective of the present study was to compare the impact of two different classes of analgesics, traditional non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclo-oxygenase-2 (COX-2) inhibitors on HRQoL among osteoarthritis patients using the SF-36 questionnaire. Methods: Clinic based cross-sectional study conducted at Al-Qassimi Hospital, Sharjah, United Arab Emirates (UAE), over a period of six months. Ethical Approval was obtained from the ethics committee at Al-Qassimi Clinical Research Center. Total of 200 osteoarthritis patients fulfilling the inclusion and exclusion criteria were involved in the study. Patients’ demographics were collected from their medical records. The Medical Outcome Study Short-Form 36 (SF-36) questionnaire was used to measure patients’ HRQoL. SF-36 data were scored using health outcomes scoring software 4.5. Results: Mean age of the subjects was 62.19 ± 9.81 years with females constituting 151 (75.5%) of the patients. In general, females scored lower in most of the HRQoL domains compared to males and there was significant difference between the two groups in the mental health (p = 0.005) & mental component (p = 0.042) domains. Compared to selective COX-2 inhibitors, patients on NSAIDs scored higher on all domains of SF-36 except physical functioning. There was significant difference in mental health domain for patients treated with NSAIDs (p = 0.02). Celecoxib was only better than NSAIDs in osteoarthritis patients with more than one musculoskeletal disorders in the domain of bodily pain (p = 0.009). Conclusion: NSAIDs-treated patients did not differ significantly from celecoxib-treated patients in all domains of the SF-36 except for the mental health domain.

Keywords

Osteoarthritis, Health Related Quality of Life, Short Form-36, Traditional Nonsteroidal Anti-Inflammatory Drugs, Selective COX-2 Inhibitors

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Bryant, D. and Alldred, A. (2007) Rheumatoid Arthritis and Osteoarthritis. In: Walker, R. and Whittlesea, C., Eds., Clinical Pharmacy and Therapeutics, 4th Edition, Churchill Livingstone, China, 759-773.
[2]	Majani, G., Giardini, A. and Scotti, A. (2005) Subjective Impact of Osteoarthritis Flare-Ups on Patients’ Quality of Life. Health and Quality of Life Outcomes, 3, 14. http://dx.doi.org/10.1186/1477-7525-3-14
[3]	Rabenda, V., Burlet, N., Ethgen, O., Raeman, F., Belaiche, J. and Reginster, J. (2005) A Naturalistic Study of the Determinants of Health Related Quality of Life Improvement in Osteoarthritic Patients Treated with Non-Specific Non-Steroidal Anti-Inflammatory Drugs. Annals of the Rheumatic Diseases, 64, 688-693. http://dx.doi.org/10.1136/ard.2004.026658
[4]	Geba, G., Weaver, A., Polis, A., Dixon, M., Schnitzer, T., et al. (2002) Efficacy of Rofecoxib, Celecoxib, and Acetaminophen in Osteoar Thritis of the Knee. JAMA: The Journal of the American Medical Association, 287, 64-71. http://dx.doi.org/10.1001/jama.287.1.64
[5]	Breedveld, F. (2004) Osteoarthritis—The Impact of a Serious Disease. Rheumatology, 43, i4-i8. http://dx.doi.org/10.1093/rheumatology/keh102
[6]	Zakaria, Z., Bakar, A., Hasmoni, H., Rani, F. and Kadir, S. (2009) Health-Related Quality of Life in Patients with Knee Osteoarthritis Attending Two Primary Care Clinics in Malaysia: A Cross-Sectional Study. Asia Pacific Family Medicine, 8, 10. http://dx.doi.org/10.1186/1447-056X-8-10
[7]	Wiklund, I. (1999) Quality of Life in Arthritis Patients Using Nonsteroidal Anti-Inflammatory Drugs. Canadian Journal of Gastroenterology, 13, 129.
[8]	Weiner, D. (2007) Office Management of Chronic Pain in the Elderly. The American Journal of Medicine, 120, 306-315. http://dx.doi.org/10.1016/j.amjmed.2006.05.048
[9]	Bijlsma, J., Berenbaum, F. and Lafeber, F. (2011) Osteoarthritis: An Update with Relevance for Clinical Practice. The Lancet, 377, 2115-2126. http://dx.doi.org/10.1016/S0140-6736(11)60243-2
[10]	Briggs, A., Scott, E. and Steele, K. (1999) Impact of Osteoarthritis and Analgesic Treatment on Quality of Life of an Elderly Population. Annals of Pharmacotherapy, 33, 1154-1159. http://dx.doi.org/10.1345/aph.18411
[11]	Dominick, K.L., Ahern, F.M., Gold, C.H. and Heller, D.A. (2004) Health-Related Quality of Life and Health Service Use among Older Adults with Osteoarthritis. Arthritis Care & Research, 51, 326-331. http://dx.doi.org/10.1002/art.20390
[12]	Lisse, J., Espinoza, L., Zhao, S., Dedhiya, S. and Osterhaus, J. (2001) Functional Status and Health-Related Quality of Life of Elderly Osteoarthritic Patients Treated with Celecoxib. The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences, 56, M167-M175. http://dx.doi.org/10.1093/gerona/56.3.M167
[13]	Brazier, J., Harper, R., Walters, S., Munro, J. and Sanith, M. (1999) Generic and Condition-Specific Outcome Measures for People with Osteoarthritis of the Knee. Rheumatology, 38, 870-877. http://dx.doi.org/10.1093/rheumatology/38.9.870
[14]	Arthritis.ae. Emirates Arthritis Foundation (2013) http://www.arthritis.ae/index.php
[15]	Rosemann, T., Laux, G. and Szecsenyi, J. (2007) Osteoarthritis: Quality of Life, Comorbidities, Medication and Health Service Utilization Assessed in a Large Sample of Primary Care Patients. Journal of Orthopaedic Surgery and Research, 2, 12. http://dx.doi.org/10.1186/1749-799X-2-12
[16]	Bakas, T., Mclennon, S., Carpenter, J., Buelow, J., Otte, J., Hanna, K., Ellett, M., Hadler, K. and Welch, J. (2012) Systematic Review of Health-Related Quality of Life Models. Health and Quality of Life Outcomes, 10, 134. http://dx.doi.org/10.1186/1477-7525-10-134
[17]	Angst, F., Aeschlimann, A., Steiner, W. and Stucki, G. (2001) Responsiveness of the WOMAC Osteoarthritis Index as Compared with the SF-36 in Patients with Osteoarthritis of the Legs Undergoing a Comprehensive Rehabilitation Intervention. Annals of the Rheumatic Diseases, 60, 834-840.
[18]	Woo, J., Lau, E., Lee, P., Kwok, T., Lau, W., Chan, C., Chiu, P., Li, E., Sham, A. and Lam, D. (2004) Impact of Osteoarthritis on Quality of Life in a Hong Kong Chinese Population. The Journal of Rheumatology, 31, 2433-2438.
[19]	Leveille, S., Zhang, Y., Mcmullen, W., Kelly-Hayes, M. and Felson, D. (2005) Sex Differences in Musculoskeletal Pain in Older Adults. Pain, 116, 332-338. http://dx.doi.org/10.1016/j.pain.2005.05.002
[20]	Dominick, K.L., Ahern, F.M., Gold, C.H. and Heller, D. (2003) Gender Differences in NSAID Use among Older Adults with Osteoarthritis. Annals of Pharmacotherapy, 37, 1566-1571. http://dx.doi.org/10.1345/aph.1C418
[21]	Chen, Y., Jobanputra, P., Barton, P., Bryan, S., Fry-Smith, A., Harris, G. and Taylor, R. (2008) Cyclooxygenase-2 Selective Non-Steroidal Anti-Inflammatory Drugs (Etodolac, Meloxicam, Celecoxib, Rofecoxib, Etoricoxib, Valdecoxib and Lumiracoxib) for Osteoarthritis and Rheumatoid Arthritis: A Systematic Review and Economic Evaluation. NIHR Evaluation, Trials and Studies Coordinating Centre (UK).
[22]	Yocum, D., Fleischmann, R., Dalgin, P., Caldwell, J., Hall, D. and Roszko, P. (2000) Safety and Efficacy of Meloxicam in the Treatment of Osteoarthritis: A 12-Week, Double-Blind, Multiple-Dose, Placebo-Controlled Trial. JAMA Internal Medicine, 160, 2947-2954. http://dx.doi.org/10.1001/archinte.160.19.2947
[23]	Van Dijk, G.M., Veenhof, C., Schellevis, F., Hulsmans, H., Bakker, J.P., Arwert, H., Dekker, J.H., Lankhorst, G.J. and Dekker, J. (2008) Comorbidity, Limitations in Activities and Pain in Patients with Osteoarthritis of the Hip or Knee. BMC Musculoskeletal Disorders, 9, 95. http://dx.doi.org/10.1186/1471-2474-9-95
[24]	Centers for Disease Control and Prevention (2000) Measuring Healthy Days: Population Assessment of Health-Related Quality of Life. Centers for Disease Control and Prevention, Atlanta.