A Systematic Review of the Incidence, Prevalence, Costs, and Activity and Work Limitations of Amputation, Osteoarthritis, Rheumatoid Arthritis, Back Pain, Multiple Sclerosis, Spinal Cord Injury, Stroke, and Traumatic Brain Injury in the United States: A 2019 Update.
Jessica Lo, Leighton Chan, Spencer Flynn
PMID 32339483WHAT IT FOUND
Back pain affected 33.9% of US adults in the past 3 months, osteoarthritis affected 32.5 million adults, and older adults with stroke were 65 to 121 percent more likely to need help with daily activities.
Key findings
01Osteoarthritis affected 32.5 million adults, and the all-cause direct cost of patients with osteoarthritis was $373.2 billion.
02Back pain was reported by 33.9% of adults in the past 3 months, and all-cause direct healthcare costs for individuals with back pain totaled $315.0 billion annually.
03Older adults with stroke were 65 to 121 percent more likely than matched controls to need help with self-care, mobility, and household activities.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review treats conditions as if they occur alone, but many patients have multiple conditions, so costs and limitations may overlap. Only English-language US adult studies with primary data were included, and some data were older than the publication date. 19 of 36 cost studies were graded poor quality, and activity and work limitation studies were not quality graded because methods and outcomes varied. Prevalence estimates for spinal cord injury and traumatic brain injury varied widely, and the authors caution against drawing too many comparisons between conditions. Stroke activity and work limitation data mostly apply to older adults, and work data are limited because many have retired.
Declared interests
The supplied metadata lists NIH Intramural research support. The article text does not include an author conflicts-of-interest declaration.
The easy way to misread this
Do not read $315.0 billion and $373.2 billion as proof that back pain and osteoarthritis need more rehabilitation resources than stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, rheumatoid arthritis, or amputation. The review says prevalence and aggregated medical costs provide only part of the information needed, and methodological variability makes direct comparisons difficult.