(337) Prevalence, characteristics, and prescription pain medication use in the osteoarthritis population

Background: Osteoarthritis (OA) is the most common joint disorder among older individuals and affects over 32 million adults in the US. OA-related chronic pain and high-impact chronic pain symptoms (chronic pain that frequently limits life or work activities) often drive individuals to seek prolonged medical care and may lead to decreased quality of life, opioid dependence, and limited functional mobility. Characterization of the epidemiology of OA in the US informs efforts to develop new therapies for this population to alleviate disease burden and improve symptoms of chronic pain.

Objectives: To estimate the most recent prevalence of OA in the US using the 2017-2020 National Health and Nutrition Examination Survey (NHANES) survey data and to describe changes in the utilization of prescription medications for pain between 2009-2010 to 2017-2020.

Methods: NHANES is a nationally representative, cross-sectional, biannual survey conducted by the US National Center for Health Statistics used to estimate OA prevalence per 100 and 95% confidence intervals (CI). OA diagnosis was based on self-report among participants aged ≥20 years. Select demographics, comorbidities, and clinical conditions were compared between participants with OA and a reference population without arthritis using standardized mean differences (SMDs). The proportion of participants with OA self-reporting use of prescription pain medications in the prior 30 days was also compared between 2009-2010 and 2017-2020.

Results: After weighting, the prevalence of OA was 13.8 per 100 (95% CI: 12.1,15.6), corresponding with 33,202,547 individuals in the US. OA prevalence increased across age groups of 20-39 years (2.5 per 100; 95% CI 1.8,3.4), 40-64 years (15.1 per 100; 95% CI 12.7,17.6), and ≥65 years (30.6 per 100, 95% CI 27.5,33.9). OA patients were older (mean age 62 vs. 43 years; SMD=-1.2), had a higher proportion of females (67.0% vs 48.9%; SMD=0.4), diabetes (18.8% vs. 8.4%; SMD=0.3), hypertension (56.7% vs. 24.1%; SMD=0.7), and coronary heart disease (11.2% vs. 2.3%; SMD=0.4) than individuals without arthritis. The use of prescription opioids (30.3% vs. 26.1%) decreased in the OA population from 2009-2010 to 2017-2020, while the use of NSAIDS (25.2% vs. 31.6%), gabapentinoids (13.9% vs. 24.4%), and skeletal muscle relaxants (12.9% vs. 15.1%) increased between the two survey cycles.

Conclusions: The prevalence of OA between 2017-2020 in the US is high with significant burden of comorbidities and prescription medication use for pain management. Changes over time in the use of medications to alleviate pain symptoms may reflect a shift away from prescription opioids toward alternative therapeutic approaches.