Musculoskeletal Health Status in Europe
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eumusc.net Musculoskeletal Health in Europe Report v5.0 Report v5.0 Musculoskeletal Health in Europe TABLE OF CONTENTS List of Figures ............................................................ 5 List of Tables ............................................................. 8 Introduction ............................................................... 9 Incidence and prevalence ............................................. 10 Data sources ......................................................................... 11 Musculoskeletal pain ............................................................... 13 Musculoskeletal pain incidence and prevalence ............................................... 13 Osteoarthritis ........................................................................ 17 Osteoarthritis incidence and prevalence ....................................................... 18 Osteoarthritis co-morbidities and mortality .................................................... 22 Rheumatoid arthritis ............................................................... 23 Rheumatoid arthritis incidence and prevalence ............................................... 24 Rheumatoid arthritis co-morbidities and mortality ........................................... 27 Low back pain ....................................................................... 29 Low back pain incidence and prevalence ....................................................... 29 Low back pain and co-morbidities ............................................................... 32 Osteoporosis ......................................................................... 33 Osteoporosis incidence and prevalence ......................................................... 33 Osteoporosis co-morbidities and mortality ..................................................... 38 Gout ................................................................................... 39 Gout incidence and prevalence .................................................................. 40 Gout co-morbidities and mortality ............................................................... 41 Juvenile Idiopathic Arthritis ...................................................... 42 JIA incidence and prevalence ..................................................................... 42 JIA co-morbidities and mortality ..................................................................... 43 Work related musculoskeletal disorders and trauma ............. 44 Risk Factors .......................................................................... 44 Prevalence of MSDs ................................................................. 45 Work-related musculoskeletal injuries .......................................... 49 Impact on population health - disability and mortality ........... 53 MSC & Disability Adjusted Life Years ............................................................ 53 MSC & Years Lived with Disability ................................................................ 57 MSC related mortality .............................................................................. 61 Determinants of Musculoskeletal Health ............................ 64 v5 Final 2 Report v5.0 Musculoskeletal Health in Europe Age .................................................................................... 64 Obesity ............................................................................... 66 Physical activity and exercise .................................................... 68 Diet and nutrition ................................................................... 69 Alcohol ................................................................................ 70 Smoking ............................................................................... 71 Accidents and injuries - sport, occupational, RTAs, falls .................... 72 Occupational injuries .............................................................................. 73 Road traffic accidents ............................................................................. 74 Changing lifestyles and the prevention of musculoskeletal conditions .... 75 Management of Musculoskeletal Conditions ........................ 76 Strategies to prevent MSC ......................................................... 77 For whole population .............................................................................. 78 The At Risk Population ............................................................................. 79 Early Disease ........................................................................................ 79 Established Conditions ............................................................................. 81 Health Services Utilisation ............................................ 85 Hospital services utilisation – average length of stay ......................... 85 Hospital services utilisation – hospital discharges ............................. 86 Hospital services utilisation - Age-standardised admission rates ........... 88 Hospital services utilisation - day cases ......................................... 89 Variation in utilisation of hospital services for MSC ........................... 90 Hospital services utilisation - Number of surgeries hip and knee arthroplasty .......................................................................... 92 Health Services Utilisation - Primary & Community Care .................... 95 Human resources .................................................................... 99 Rheumatologists .................................................................................... 99 Orthopaedic Specialists .......................................................................... 100 Occupational Therapists ......................................................................... 101 Physiotherapists ................................................................................... 102 Diagnostic equipment ............................................................ 103 Drug use ............................................................................ 104 Self-reported medication use for MSC ......................................................... 105 Pharmaceuticals consumption for MSC ........................................................ 107 Pharmaceuticals sales for MSC.................................................................. 109 International variation in use of TNF inhibitors & DMARD .................................. 113 Impact on the individual ............................................. 114 Measuring the impact of disease on quality of life .......................... 114 v5 Final 3 Report v5.0 Musculoskeletal Health in Europe Impact of Rheumatoid Arthritis on Quality of Life .......................................... 116 Impact of Osteoarthritis and Osteoporosis on Quality of Life ............................. 118 Impact of hip fracture on Quality of Life ..................................................... 118 QoL in patients with MSC compared to other conditions ................................... 118 Comparing Quality of Life between musculoskeletal conditions .......................... 120 Differences between countries in MSC related quality of life ............................. 120 Improvements in Quality of Life ................................................................ 120 Musculoskeletal conditions and work disability .............................. 121 QUEST-RA study ................................................................................... 122 TNF treatment of RA - sick leave & disability ................................................ 123 Disability and poverty ............................................................................ 124 Impact on carers .................................................................................. 125 Impact on Society ..................................................... 126 Health care costs ................................................................. 126 Work loss and productivity ...................................................... 132 Musculoskeletal conditions and disability costs .............................. 140 Health inequalities and musculoskeletal conditions ............. 145 Health care inequalities ......................................................... 148 MSC and socioeconomic status.................................................................. 149 Age and gender ................................................................................... 151 Ethnicity ............................................................................................ 151 Equity of access to MSC treatments across the EU .......................... 152 Regional inequalities in access to MSC health care ......................... 153 Conclusion .............................................................. 157 References .............................................................. 160 Acknowledgements .................................................... 181 v5 Final 4 Report v5.0 Musculoskeletal Health in Europe List of Figures Figure 1 Eurobarometer 2007 – percentage of respondents reporting health conditions (current or ever had). ................................................................................... 11 Figure 2 Substantial pain in the last 3 & 12 months, Austria 2006 ............................... 13 Figure 3 Prevalence of musculoskeletal pain The Netherlands 2003............................. 14 Figure 4