Pos0129-HPR Association Between Depression and Outcome Regarding Pain After Participation in a First-Line Intervention Program for Knee and Hip Osteoarthritis. A Study From the Swedish Osteoarthritis Register

Background: Depression has been shown to contribute to poorer patient-reported outcomes after joint replacement surgery in patients with knee and hip osteoarthritis (OA). However, it is not known how depression before participation in a first-line intervention OA program affects the outcome of the intervention. Objectives: To evaluate if medically treated depression, identified before participation in first-line intervention, is associated with poorer outcome regarding pain after the intervention among patients with knee and/or hip OA. Methods: In this longitudinal observational register-based cohort study, we included 44,311 patients who had participated in a first-line OA intervention program including patient education and exercise. All data was extracted from the Swedish Osteoarthritis Register between 2008 and 2016. Patients were stratified by most affected joint into a knee OA- and a hip OA cohort. Multiple logistic regression was used to assess the association between medically treated depression during the 3 years before baseline and patient-reported deterioration in pain (≥2 on a numeric rating scale) from baseline to the 3-month follow-up after participation in the first-line OA intervention program. We adjusted for baseline variables; age, sex, educational level, pain intensity, BMI, Charnley score, supervised exercises and desire for surgery. Results: Sixteen percent (n=2,224/13,787) of patients with knee OA and 16% (n=4,968/30,524) of patients with hip OA had medically treated depression before participation in the first-line OA intervention program. The adjusted analyses showed an association between depression and deterioration in pain after participating in first-line OA intervention for patients with knee OA (OR; 1.25 [95% CI, 1.11-1.40], but no statistically significant association was found in patients with hip OA (OR; 1.10 [95% CI, 0.94-1.29]). Conclusion: Poorer outcome regarding pain after 3-months participation in a first-line OA intervention program was influenced by having medically treated depression before inclusion in the program, in patients with knee OA but not in patients with hip OA. To optimize the use of health care resources, future research should focus on identifying what support patients with knee OA and depression need to improve the results from a first-line OA intervention. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: Kristin Gustafsson: None declared, Joanna Kvist: None declared, Therese Jönsson: None declared, Marit Eriksson: None declared, Ola Rolfson Novartis (advisor board), AstraZenica (reaearch advisor), Pfizer (institutional research support as PI).