Outcome of Pain in Hand Osteoarthritis Save
Leiden cohort study of hand osteoarthritis (HOA) patients shows that over 4 years, pain outcomes are variable, and not inevitably worsening.
A total of 356 HOA patients (83% female, mean 60 years) were enrolled from the Hand OSTeoArthritis in Secondary care (HOSTAS) cohort. Outcomes were assessed using annual Australian/Canadian hand osteoarthritis index (AUSCAN) pain subscale (range 0-20) measurements. Pain changes were categorized as deterioration, stable and improvement using the Minimal Clinical Important Improvement (MCII).
Four year outcomes showed pain :
- mproved for 38%,
- deteriorated for 30%
- remained stable for 32%
Pain worsening was associated with higher BMI, coping through comforting cognitions and illness comprehension
Pain improvement was associated with higher AUSCAN function score, mental wellbeing and illness consequences.
Higher baseline AUSCAN function, tender joint count and symptoms attributed to hand OA were associated negatively with Patient Acceptable Symptom State (PASS) after four years.
Pain outcomes in HOA are variable, but not all worsen. Risk factors affecting pain outcomes requires further investigation.
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