The journals of gerontology. Series A, Biological sciences and medical sciences, Jan 17, 2018
We describe the recruitment of participants for Strategies to Reduce Injuries and Develop Confide... more We describe the recruitment of participants for Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE), a large pragmatic cluster randomized trial that is testing the effectiveness of a multifactorial intervention to prevent serious fall injuries. Eligible persons were 70 years or older, community-living, and at increased risk for serious fall injuries. The modified goal was to recruit 5,322 participants over 20 months from 86 primary care practices within 10 diverse health care systems across the United States. The at-risk population was identified using two distinct but complementary screening strategies that included three questions administered centrally via the mail (nine sites) or in the clinic (one site), while recruitment was completed centrally by staff at Yale. For central screening, 226,603 letters mailed to 135,118 patients yielded 28,719 positive screens (12.7% of those mailed and 46.5% of the 61,729 returned). In the clinic, 22,537 screens were complet...
Additional file 1: Post-hoc univariate analyses of the factors independently associated with radi... more Additional file 1: Post-hoc univariate analyses of the factors independently associated with radiographic osteoarthritis progression at two years: number (%) of people using NSAIDs and people not meeting physical activity guidelines, respectively. P values for association between independent variables and primary outcomes using Pearson χ2.
Background The aim of this study was to identify modifiable clinical factors associated with radi... more Background The aim of this study was to identify modifiable clinical factors associated with radiographic osteoarthritis progression over 1 to 2 years in people with painful medial knee osteoarthritis. Methods A longitudinal study was conducted within a randomised controlled trial, the “Long-term Evaluation of Glucosamine Sulfate” (LEGS study). Recruitment occurred in 2007–2009, with 1- and 2-year follow-up assessments by blinded assessors. Community-dwelling people with chronic knee pain (≥4/10) and medial tibiofemoral narrowing (but retaining >2mm medial joint space width) on radiographs were recruited. From 605 participants, follow-up data were available for 498 (82%, mean [sd] age 60 [8] years). Risk factors evaluated at baseline were pain, physical function, use of non-steroidal anti-inflammatory drugs (NSAIDs), statin use, not meeting physical activity guidelines, presence of Heberden’s nodes, history of knee surgery/trauma, and manual occupation. Multivariable logistic reg...
ABSTRACT Background With an ageing population and increased trend to delay retirement worldwide, ... more ABSTRACT Background With an ageing population and increased trend to delay retirement worldwide, the number of people in the workforce affected by knee osteoarthritis will increase(1). There is a paucity of research examining the burden of work disability among people with knee osteoarthritis(2). Previous population and patient-based surveys have mostly been limited to evaluating absenteeism and have all required lengthy recall periods(2). Objectives To determine the burden and risk factors associated with work disability (absenteeism and presenteeism) among people with chronic knee pain. Methods A longitudinal study nested within a randomised controlled trial evaluating the long-term effect of dietary supplements. The study cohort consisted of the 336 (55%) trial participants in paid employment. A Participant Diary required reporting on days off work (absenteeism) and reduced productivity while at work (presenteeism) for seven days, every two months over a 12 month follow up period. Baseline risk factors included knee pain, patient global assessment, occupational group, radiographic disease severity, physical activity, body mass index, health-related quality of life (SF-12) and self-reported co-morbidity. Results Among the 336 participants in paid employment, 36 (12%) withdrew from the LEGS study during the 12 month follow up period. A total of 219 (65%) completed all six Participant Diaries while 269 (80%) completed at least five of the six Participant Diaries. Most participants were in professional and managerial roles (46%) and less than 60 years of age (69%). While all participants had medial tibiofemoral joint space narrowing in at least one knee, most knees were Kellgren and Lawrence grade 1 or 2 (∼90%) indicating mild to moderate radiographic disease(3). Over the 12 month follow up period, 44 (13%) participants reported 1 or more days off work due to knee problems. Almost half (43%) of the cohort reported <90% work productivity due to their knee problems over the 12 month follow up period. In multivariate analysis, the only significant risk factor for absenteeism was SF-12 PCS <40 (OR: 3.70 [95% CI: 1.34-10.18]). Significant risk factors for presenteeism included; aged 55 - 64 years (OR: 1.92 [1.02-3.61]), SF-12 PCS <49 (OR: 1.94 [95% CI: 1.01-3.73), manual work (OR: 7.63 [1.67-34.79]) and maximum knee pain rated as 4 – 6 (out of 10) (OR: 2.11 [1.08-4.16]). Conclusions This longitudinal study demonstrated marked work disability among people with chronic knee pain, but mostly only mild radiographic disease severity. Physical disability, older age, manual labour and knee pain were clearly associated with reduced productivity while at work. Disclosure of Interest None Declared
Worldwide, osteoarthritis (OA) is estimated to be the fourth leading cause of disability. Most of... more Worldwide, osteoarthritis (OA) is estimated to be the fourth leading cause of disability. Most of this disability burden is attributable to the involvement of the hips or the knees. OA is strongly associated with ageing and the Asian region is ageing rapidly. Further, OA has been associated with heavy physical occupational activity, a required livelihood for many people living in rural communities in developing countries. Unfortunately, joint replacement surgery, an effective intervention for people with severe OA involving the hips or knees, is inaccessible to most people in these regions. On the other hand, obesity, another major risk factor, may be less prevalent, although it is on the increase. Determining region-specific OA prevalence and risk factor profiles will provide important information for planning future cost-effective preventive strategies and health care services. An update of what is currently known about the prevalence of hip and knee OA from population-based studies conducted in the Asian region is presented in this review. Many of the recent studies have conducted comparisons between urban and rural areas and poor and affluent communities. The results of Asian-based studies evaluating risk factors from population-based cohorts or case-control studies, and the current evidence on OA morbidity burden in Asia is also outlined.
To estimate the global burden of hip and knee osteoarthritis (OA) as part of the Global Burden of... more To estimate the global burden of hip and knee osteoarthritis (OA) as part of the Global Burden of Disease 2010 study and to explore how the burden of hip and knee OA compares with other conditions. Systematic reviews were conducted to source age-specific and sex-specific epidemiological data for hip and knee OA prevalence, incidence and mortality risk. The prevalence and incidence of symptomatic, radiographic and self-reported hip or knee OA were included. Three levels of severity were defined to derive disability weights (DWs) and severity distribution (proportion with mild, moderate and severe OA). The prevalence by country and region was multiplied by the severity distribution and the appropriate disability weight to calculate years of life lived with disability (YLDs). As there are no deaths directly attributed to OA, YLDs equate disability-adjusted life years (DALYs). Globally, of the 291 conditions, hip and knee OA was ranked as the 11th highest contributor to global disability and 38th highest in DALYs. The global age-standardised prevalence of knee OA was 3.8% (95% uncertainty interval (UI) 3.6% to 4.1%) and hip OA was 0.85% (95% UI 0.74% to 1.02%), with no discernible change from 1990 to 2010. Prevalence was higher in females than males. YLDs for hip and knee OA increased from 10.5 million in 1990 (0.42% of total DALYs) to 17.1 million in 2010 (0.69% of total DALYs). Hip and knee OA is one of the leading causes of global disability. Methodological issues within this study make it highly likely that the real burden of OA has been underestimated. With the aging and increasing obesity of the world's population, health professions need to prepare for a large increase in the demand for health services to treat hip and knee OA.
The journals of gerontology. Series A, Biological sciences and medical sciences, Jan 17, 2018
We describe the recruitment of participants for Strategies to Reduce Injuries and Develop Confide... more We describe the recruitment of participants for Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE), a large pragmatic cluster randomized trial that is testing the effectiveness of a multifactorial intervention to prevent serious fall injuries. Eligible persons were 70 years or older, community-living, and at increased risk for serious fall injuries. The modified goal was to recruit 5,322 participants over 20 months from 86 primary care practices within 10 diverse health care systems across the United States. The at-risk population was identified using two distinct but complementary screening strategies that included three questions administered centrally via the mail (nine sites) or in the clinic (one site), while recruitment was completed centrally by staff at Yale. For central screening, 226,603 letters mailed to 135,118 patients yielded 28,719 positive screens (12.7% of those mailed and 46.5% of the 61,729 returned). In the clinic, 22,537 screens were complet...
Additional file 1: Post-hoc univariate analyses of the factors independently associated with radi... more Additional file 1: Post-hoc univariate analyses of the factors independently associated with radiographic osteoarthritis progression at two years: number (%) of people using NSAIDs and people not meeting physical activity guidelines, respectively. P values for association between independent variables and primary outcomes using Pearson χ2.
Background The aim of this study was to identify modifiable clinical factors associated with radi... more Background The aim of this study was to identify modifiable clinical factors associated with radiographic osteoarthritis progression over 1 to 2 years in people with painful medial knee osteoarthritis. Methods A longitudinal study was conducted within a randomised controlled trial, the “Long-term Evaluation of Glucosamine Sulfate” (LEGS study). Recruitment occurred in 2007–2009, with 1- and 2-year follow-up assessments by blinded assessors. Community-dwelling people with chronic knee pain (≥4/10) and medial tibiofemoral narrowing (but retaining >2mm medial joint space width) on radiographs were recruited. From 605 participants, follow-up data were available for 498 (82%, mean [sd] age 60 [8] years). Risk factors evaluated at baseline were pain, physical function, use of non-steroidal anti-inflammatory drugs (NSAIDs), statin use, not meeting physical activity guidelines, presence of Heberden’s nodes, history of knee surgery/trauma, and manual occupation. Multivariable logistic reg...
ABSTRACT Background With an ageing population and increased trend to delay retirement worldwide, ... more ABSTRACT Background With an ageing population and increased trend to delay retirement worldwide, the number of people in the workforce affected by knee osteoarthritis will increase(1). There is a paucity of research examining the burden of work disability among people with knee osteoarthritis(2). Previous population and patient-based surveys have mostly been limited to evaluating absenteeism and have all required lengthy recall periods(2). Objectives To determine the burden and risk factors associated with work disability (absenteeism and presenteeism) among people with chronic knee pain. Methods A longitudinal study nested within a randomised controlled trial evaluating the long-term effect of dietary supplements. The study cohort consisted of the 336 (55%) trial participants in paid employment. A Participant Diary required reporting on days off work (absenteeism) and reduced productivity while at work (presenteeism) for seven days, every two months over a 12 month follow up period. Baseline risk factors included knee pain, patient global assessment, occupational group, radiographic disease severity, physical activity, body mass index, health-related quality of life (SF-12) and self-reported co-morbidity. Results Among the 336 participants in paid employment, 36 (12%) withdrew from the LEGS study during the 12 month follow up period. A total of 219 (65%) completed all six Participant Diaries while 269 (80%) completed at least five of the six Participant Diaries. Most participants were in professional and managerial roles (46%) and less than 60 years of age (69%). While all participants had medial tibiofemoral joint space narrowing in at least one knee, most knees were Kellgren and Lawrence grade 1 or 2 (∼90%) indicating mild to moderate radiographic disease(3). Over the 12 month follow up period, 44 (13%) participants reported 1 or more days off work due to knee problems. Almost half (43%) of the cohort reported <90% work productivity due to their knee problems over the 12 month follow up period. In multivariate analysis, the only significant risk factor for absenteeism was SF-12 PCS <40 (OR: 3.70 [95% CI: 1.34-10.18]). Significant risk factors for presenteeism included; aged 55 - 64 years (OR: 1.92 [1.02-3.61]), SF-12 PCS <49 (OR: 1.94 [95% CI: 1.01-3.73), manual work (OR: 7.63 [1.67-34.79]) and maximum knee pain rated as 4 – 6 (out of 10) (OR: 2.11 [1.08-4.16]). Conclusions This longitudinal study demonstrated marked work disability among people with chronic knee pain, but mostly only mild radiographic disease severity. Physical disability, older age, manual labour and knee pain were clearly associated with reduced productivity while at work. Disclosure of Interest None Declared
Worldwide, osteoarthritis (OA) is estimated to be the fourth leading cause of disability. Most of... more Worldwide, osteoarthritis (OA) is estimated to be the fourth leading cause of disability. Most of this disability burden is attributable to the involvement of the hips or the knees. OA is strongly associated with ageing and the Asian region is ageing rapidly. Further, OA has been associated with heavy physical occupational activity, a required livelihood for many people living in rural communities in developing countries. Unfortunately, joint replacement surgery, an effective intervention for people with severe OA involving the hips or knees, is inaccessible to most people in these regions. On the other hand, obesity, another major risk factor, may be less prevalent, although it is on the increase. Determining region-specific OA prevalence and risk factor profiles will provide important information for planning future cost-effective preventive strategies and health care services. An update of what is currently known about the prevalence of hip and knee OA from population-based studies conducted in the Asian region is presented in this review. Many of the recent studies have conducted comparisons between urban and rural areas and poor and affluent communities. The results of Asian-based studies evaluating risk factors from population-based cohorts or case-control studies, and the current evidence on OA morbidity burden in Asia is also outlined.
To estimate the global burden of hip and knee osteoarthritis (OA) as part of the Global Burden of... more To estimate the global burden of hip and knee osteoarthritis (OA) as part of the Global Burden of Disease 2010 study and to explore how the burden of hip and knee OA compares with other conditions. Systematic reviews were conducted to source age-specific and sex-specific epidemiological data for hip and knee OA prevalence, incidence and mortality risk. The prevalence and incidence of symptomatic, radiographic and self-reported hip or knee OA were included. Three levels of severity were defined to derive disability weights (DWs) and severity distribution (proportion with mild, moderate and severe OA). The prevalence by country and region was multiplied by the severity distribution and the appropriate disability weight to calculate years of life lived with disability (YLDs). As there are no deaths directly attributed to OA, YLDs equate disability-adjusted life years (DALYs). Globally, of the 291 conditions, hip and knee OA was ranked as the 11th highest contributor to global disability and 38th highest in DALYs. The global age-standardised prevalence of knee OA was 3.8% (95% uncertainty interval (UI) 3.6% to 4.1%) and hip OA was 0.85% (95% UI 0.74% to 1.02%), with no discernible change from 1990 to 2010. Prevalence was higher in females than males. YLDs for hip and knee OA increased from 10.5 million in 1990 (0.42% of total DALYs) to 17.1 million in 2010 (0.69% of total DALYs). Hip and knee OA is one of the leading causes of global disability. Methodological issues within this study make it highly likely that the real burden of OA has been underestimated. With the aging and increasing obesity of the world's population, health professions need to prepare for a large increase in the demand for health services to treat hip and knee OA.
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Papers by Lisa Bridgett