Pain coping style and health care use in patients with early knee and/or hip osteoarthritis: 10-year CHECK cohort study

Abstract

Introduction: Osteoarthritis (OA) is one of the most common chronic joint conditions worldwide among older adults. Pain is often the main reason to use health care services. In order to manage pain, people use active or passive pain coping strategies. Aim: To determine the relationship between pain coping style in an early stage of OA and the course of health care use in patients with early knee and/or hip OA, with a 10-year follow-up. Methods: Baseline and 10-year follow-up data of 861 Dutch participants with early knee and/or hip OA from the multicenter Cohort Hip and Cohort Knee (CHECK) cohort were used. Health care use (HCU) was measured annually with a self-administered questionnaire, indicating how many health care services were used (range 0-20). Pain coping style (active or passive) was measured at baseline using the Pain Coping Inventory (PCI). Descriptive statistics were used to examine baseline characteristics and the course of mean HCU over ten years. Poisson Generalized Estimating Equations (GEE) was performed to determine the relationship between pain coping style and HCU over ten years. Results: At baseline, the majority of the participants had an active coping style (73.7%). Over ten years, the mean of used health care services in participants with an active coping style ranged from 1.15 (± 1.07) to 1.42 (± 1.19), and in participants with a passive coping style from 0.96 (± 0.98) to 1.34 (±1.16). Analysis showed that having an active pain coping style was significantly (p<0.001) associated with an increase of 22.5% (95% CI, 9.3-37.3) in the number of used health care services over ten years. Conclusion: This study showed that having an active pain coping style in an early stage of knee and/or hip OA leads to the use of more health care services over ten years, as opposed to having a passive pain coping style. Consequently, actions must be taken by health care professionals in order to prevent high long-term use of health care services in patients with an active coping style.