The impact of waiting time for orthopaedic consultation on pain levels in individuals with osteoarthritis: a systematic review and meta-analysis,Osteoarthritis and Cartilage

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The impact of waiting time for orthopaedic consultation on pain levels in individuals with osteoarthritis: a systematic review and meta-analysis
Osteoarthritis and Cartilage ( IF 7.2 ) Pub Date : 2022-08-10 , DOI: 10.1016/j.joca.2022.07.007
R K Patten ₁ , A Tacey ₁ , M Bourke ₂ , C Smith ₃ , M Pascoe ₁ , S Vogrin ₄ , A Parker ₁ , M J McKenna ₁ , P Tran ₅ , M De Gori ₆ , C M Said ₇ , V Apostolopoulos ₁ , R Lane ₁ , M N Woessner ₁ , I Levinger ₈

Affiliation

Institute for Health and Sport, Victoria University, Melbourne, Australia.
Institute for Health and Sport, Victoria University, Melbourne, Australia; School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Canada.
Institute for Health and Sport, Victoria University, Melbourne, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, University of Melbourne and Western Health, Melbourne, Australia.
Department of Medicine, The University of Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, University of Melbourne and Western Health, Melbourne, Australia.
Institute for Health and Sport, Victoria University, Melbourne, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, University of Melbourne and Western Health, Melbourne, Australia; Department of Orthopaedic Surgery, Western Health, Melbourne, Australia.
Physiotherapy, Western Health, Melbourne, Australia.
Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, University of Melbourne and Western Health, Melbourne, Australia; Physiotherapy, Western Health, Melbourne, Australia; Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia.
Institute for Health and Sport, Victoria University, Melbourne, Australia; Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, University of Melbourne and Western Health, Melbourne, Australia.

Objective

Time spent waiting for access to orthopaedic specialist health services has been suggested to result in increased pain in individuals with osteoarthritis (OA). We assessed whether time spent on an orthopaedic waiting list resulted in a detrimental effect on pain levels in patients with knee or hip OA.

Methods

We searched Ovid MEDLINE, EMBASE and EBSCOhost databases from inception until September 2021. Eligible articles included individuals with OA on an orthopaedic waitlist and not receiving active treatment, and reported pain measures at two or more time points. Random-effects meta-analysis was used to estimate the pooled effect of waiting time on pain levels. Meta-regression was used to determine predictors of effect size.

Results

Thirty-three articles were included (n = 2,490 participants, 67 ± 3 years and 62% female). The range of waiting time was 2 weeks to 2 years (20.8 ± 18.8 weeks). There was no significant change in pain over time (effect size = 0.082, 95% CI = −0.009, 0.172), nor was the length of time associated with longitudinal changes in pain over time (β = 0.004, 95% CI = −0.005, 0.012). Body mass index was a significant predictor of pain (β = −0.043, 95% CI = −0.079, 0.006), whereas age and sex were not.

Conclusions

Pain remained stable for up to 1 year in patients with OA on an orthopaedic waitlist. Future research is required to understand whether pain increases in patients waiting longer than 1 year.

中文翻译：

骨科咨询等待时间对骨关节炎患者疼痛水平的影响：系统评价和荟萃分析

客观的

研究表明，等待获得骨科专科医疗服务所花费的时间会增加骨关节炎 (OA) 患者的疼痛。我们评估了在骨科等候名单上花费的时间是否会对膝关节或髋关节 OA 患者的疼痛水平产生不利影响。

方法

我们搜索了 Ovid MEDLINE、EMBASE 和 EBSCOhost 数据库，从开始到 2021 年 9 月。符合条件的文章包括在骨科候补名单上患有 OA 且未接受积极治疗，并报告了两个或更多时间点的疼痛测量值的个体。随机效应荟萃分析用于估计等待时间对疼痛水平的综合影响。元回归用于确定效应大小的预测因子。

结果

包括 33 篇文章（n = 2,490 名参与者，67 ± 3 岁，62% 为女性）。等待时间范围为 2 周至 2 年（20.8 ± 18.8 周）。疼痛随时间没有显着变化（效应大小 = 0.082，95% CI = −0.009，0.172），时间长度也与疼痛随时间的纵向变化无关（β = 0.004，95% CI = −0.005 , 0.012). 体重指数是疼痛的重要预测因子 ( β = -0.043, 95% CI = -0.079, 0.006)，而年龄和性别则不是。