The burden of musculoskeletal diseases in the general population of Spain: results from a national survey

TLDR

The EPISER study aimed to estimate the prevalence of rheumatoid arthritis, low back pain, hand and knee osteoarthritis, and fibromyalgia in adults in Spain and to evaluate their impact on function, quality of life, and health resource use. The study recruited 2,998 adults (≥20 years) through stratified multistage cluster sampling and had trained rheumatologists perform structured visits that included symptom questionnaires, sociodemographic data, HAQ and SF‑12 assessments, and physical examinations, with cases identified by validated criteria. The prevalence estimates were 0.5% for rheumatoid arthritis, 14.8% for low back pain, 10.2% for symptomatic knee osteoarthritis, 6.2% for hand osteoarthritis, and 2.4% for fibromyalgia; these conditions markedly impaired function and quality of life and led to substantial physician visits, work disability, and medication use.

Abstract

<h3>OBJECTIVE</h3> The objective of the EPISER study was to estimate the prevalence of rheumatoid arthritis (RA), low back pain, hand and knee osteoarthritis (OA), and fibromyalgia in the adult Spanish population, and to assess the impact of these diseases on function and quality of life, and use of health and social resources. <h3>METHODS</h3> 2998 subjects aged 20 years or above were randomly selected by stratified multistage cluster sampling from the censuses of 20 municipalities. Trained rheumatologists carried out structured visits at which subjects were asked about rheumatic symptoms and sociodemographic characteristics, completed validated instruments for measuring function (HAQ) and quality of life (SF-12), and underwent a standardised physical examination. Cases were defined by previously validated criteria. <h3>RESULTS</h3> The estimated prevalences with 95% confidence intervals were as follows: RA lifetime cumulative: 0.5% (0.3 to 0.9); low back pain: 14.8% (12.2 to 17.4); symptomatic knee OA: 10.2% (8.5 to 11.9); hand OA: 6.2% (5.9 to 6.5); fibromyalgia: 2.4% (1.5 to 3.2). Most conditions significantly impaired function and quality of life. <h3>CONCLUSIONS</h3> The EPISER study has internal and external validity for application of the results to the adult Spanish population. The diseases studied affect a significant proportion of the population, with various degrees of impact on disability and quality of life resulting in a significant number of physician visits, work disability, and medication use.