scholarly journals Efficacy of 10% Ichthammol Glycerine Pack and Steroid-antibiotic Pack for Relieving Pain in Acute Otitis Externa. A Comparative Study.

2019 ◽  
Vol 4 (1) ◽  
pp. 634-638
Author(s):  
Karuna Shrestha ◽  
Rajeev Shah ◽  
Srijana Sapkota
Keyword(s):  
Severe Pain ◽  
Otitis Externa ◽  
Combined Therapy ◽  
Treatment Modalities ◽  
Moderate Pain ◽  
Painful Condition ◽  
Female Ratio ◽  
Mild Pain ◽  
Number Of Patients ◽  
Antibiotic Ointment

Introduction: Otitis externa is a common painful condition presents with generalized infection of external auditory canal, typically reveals erythema and edema of the skin. Aural packing plays an important role in relieving the pain and edema. For packing, either we impregnated with 10% Ichthammol glycerine or steroid-antibiotic ointment. Objective: To compare the efficacy of 10% Ichthammol Glycerine pack with steroid-antibiotic ointment pack for relieving the pain in acute otitis externa. Methodology: A prospective, non-randomized clinical trial was carried out in 94 patients at Birat Medical College and Teaching Hospital, Biratnagar, Nepal from February 2018 to July 2018. Patients diagnosed with acute otitis externa were included in this study, where 47 patients were treated with 10% IG pack and remaining 47 patients treated with a combination steroid antibiotic ointment pack. Before aural packing was carried out, pain was assessed using visual analogue scale (VAS). Both groups of patients were evaluated after 48 hours for assessment of pain. Results: The total number of patients included in this study was 94. Among them 41 (43.6%) were male and 53(56.4%) were female where male and female ratio was 1:1.29. Majority of the patients were below 40 years (83%). Treatment with steroid-antibiotic ointment pack had significant reduction in pain after 48 hours post treatment, none of them had severe pain, 4(8.5%) had moderate pain remaining and 43(91.4%) had only mild pain. Whereas in patients treated with 10% IG pack 1(2.1%) had severe pain, 14(29.7%) had moderate pain and 32(68%) had mild pain. There was statistically significant decrease in pain with steroid-antibiotic pack. Conclusions: Both treatment modalities are effective but this study showed steroid-antibiotic ointment pack, the combined therapy is more effective than 10% IG pack for relieving the pain in acute otitis externa.

scholarly journals Steroid Antibiotic Pack Versus 10% Ichthammol Glycerol Pack in Management of Acute Otitis Externa: A Comparative Study

2021 ◽  
Vol 12 (1) ◽  
pp. 192-198
Author(s):  
Akshaya Thrinetrapriya N ◽  
Nandhini R ◽  
Shoba K
Keyword(s):  
Severe Pain ◽  
Otitis Externa ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Randomised Clinical Trial ◽  
Rapid Onset ◽  
Moderate Pain ◽  
Predisposing Factor ◽  
Mild Pain ◽  
Institutional Review

Acute otitis externa is a common clinical condition that presents with rapid onset of otalgia, fullness, otorrhea and canal oedema. Moisture in-ear canal appears to be an important predisposing factor. The most common etiological agents include Pseudomonas aeruginosa and Staphylococcus aureus. Management includes control of otalgia and elimination of infection from the ear. Precipitating factors should be avoided. The main objective of this study is to compare the efficacy of 10% ichthammol glycerol ear pack with steroid antibiotic ear pack in the treatment of acute otitis externa. Institutional Review Board (IRB) clearance was obtained, and a prospective randomised clinical trial was conducted in the ENT outpatient department of Saveetha Medical College & Hospital, Thandalam, from January 2020 to March 2020. Patients were explained about the study in detail, and consent was obtained. The patients were randomised, and 10% ichthammol glycerol pack and steroid antibiotic pack were used in alternate turns for aural packing. Pain rating was done using Numerical rating scale (NRS) before and 48 hours post-treatment and also in each subsequent hospital visit till complete subsidence of symptoms. Among the 85 patients included in the study, 42 (49.4%) were males, and 43 (50.6%) were females. Most of them belonged to the age group 31-40 years (41.2%). Tragal tenderness and external auditory canal oedema were the most common ear findings noted. In the patients treated with steroid antibiotic pack, only 2.3% of the patients had severe pain, whereas 14% had moderate pain and 83.7% had only mild pain. Whereas among those treated with 10% ichthammol glycerol pack, 9.5% of the patients had severe pain, whereas 35.7% had moderate pain and 54.8% had mild pain. On analysis, the results were statistically significant, and there was considerable pain relief with steroid antibiotic pack. Therefore, our study showed that steroid antibiotic pack is more effective in relieving the symptoms, thereby reducing the number of hospital visits when compared to 10% ichthammol glycerol pack.

scholarly journals Pain management after lung surgery

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria Frödin ◽  
Margareta Warrén Stomberg
Keyword(s):  
Quality Of Care ◽  
Pain Management ◽  
Postoperative Pain ◽  
Severe Pain ◽  
Postoperative Pain Management ◽  
Lung Surgery ◽  
Moderate Pain ◽  
Number Of Patients ◽  
Severe Postoperative Pain

Pain management is an integral challenge in nursing and includes the responsibility of managing patients’ pain, evaluating pain therapy and ensuring the quality of care. The aims of this study were to explore patients’ experiences of pain after lung surgery and evaluate their satisfaction with the postoperative pain management. A descriptive design was used which studied 51 participants undergoing lung surgery. The incidence of moderate postoperative pain varied from 36- 58% among the participants and severe pain from 11-26%, during their hospital stay. Thirty-nine percent had more pain than expected. After three months, 20% experienced moderate pain and 4% experienced severe pain, while after six months, 16% experienced moderate pain. The desired quality of care goal was not fully achieved. We conclude that a large number of patients experienced moderate and severe postoperative pain and more than one third had more pain than expected. However, 88% were satisfied with the pain management. The findings confirm the severity of pain experienced after lung surgery and facilitate the apparent need for the continued improvement of postoperative pain management following this procedure.

Pain and Health-Related Quality of Life (HRQoL) in Patients with Relapsed and Plateau-Phase (PP) Multiple Myeloma (MM) Treated with Denosumab

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2388-2388 ◽  
Author(s):  
Karen C Chung ◽  
Arie Barlev ◽  
Yi Qian ◽  
Susie Jun
Keyword(s):  
Severe Pain ◽  
Short Form ◽  
Human Monoclonal Antibody ◽  
Moderate Pain ◽  
Mild Pain ◽  
Osteoclast Activity ◽  
The Past ◽  
Hrqol Data ◽  
The Impact

Abstract BACKGROUND: MM is the second most common hematalogical malignancy in the U.S. The expansion of myeloma cells in bone, which is characteristic of MM, results in increased osteoclast activity that cause osteolytic lesions, which can lead to spinal cord compression, pathologic fracture, surgery or radiation therapy to bone, and bone pain. Denosumab is a fully human monoclonal antibody that can inhibit bone resorption by reducing the number and activity of osteoclasts by inhibiting RANK ligand, a key mediator of osteoclast activity. The objective of this analysis was to evaluate the pain and HRQoL in patients with MM being treated with denosumab. METHODS: 96 patients with either ≥2 prior treatment regimens and relapsed following a response to any conventional MM therapy (relapsed) or response to the most recent MM therapy and stable M-protein for ≥3 months (PP) were enrolled in a phase 2, multicenter, open-label, single-arm study of denosumab. Patients received 120mg denosumab SC on days 1, 8, 15, and 29 then every 28 days thereafter until disease progression or discontinuation. The Brief Pain Inventory-Short Form (BPI) and Functional Assessment of Cancer Therapy-General (FACT) were assessed at baseline (BL) and prior to treatment on day 1 of each 28-day cycle. BPI “pain at worst in the past 24 hours” scores were categorized as no pain (BPI 0), mild pain (BPI 1–4), moderate pain (BPI 5–6) or severe pain (BPI 7–10). BL and month 3 (relapsed) and month 5 (PP) pain and HRQoL data were analyzed. Longitudinal data regarding pain and HRQoL data were reported at BL and the latest assessment timepoint where <30% of patients had dropped out. RESULTS: 45 patients with relapsed MM (Table 1) and 37 patients with PP MM (Table 2) had BL and ≥1 post-BL assessment. 30% or more patients dropped out after month 3 of treatment in relapsed patients and after month 5 in PP patients. In relapsed patients, 12 (27%), 21 (47%), 8 (18%), and 4 (9%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. In PP patients, 15 (41%), 13 (35%), 5 (14%), and 4 (11%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. 68% and 89% of relapsed and PP patients, respectively, demonstrated improvement or no categorical change in pain. At BL, mean (sd) FACT total scores (0–108, higher score indicating better HRQoL) for relapsed and PP patients were 77.4 (15.3) and 82.5 (11.2), respectively. FACT total scores remained relatively constant in relapsed and PP patients, 77.9 (19.4) and 83.6 (13.3), respectively. In addition, mean change from baseline in FACT domain scores varied between 1.2 to 0.2 in relapsed patients and between 0.3 to 1.1 in PP patients. CONCLUSION: The majority of patients with relapsed and PP MM demonstrated maintenance or improvement in pain and maintenance of HRQoL during treatment with denosumab. These results suggest denosumab may be associated with stabilization of pain and maintenance of HRQoL in patients with MM. Randomized trials are needed to further understand the impact of denosumab on pain and HRQoL in patients with MM. Table 1. “Pain at Worst in the past 24 hours” Category Shift between BL and month 3 in relapsed patients (n=45). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 7 2 2 1 12 Mild 4 10 4 3 21 Moderate 2 3 1 2 8 Severe 0 0 2 2 4 TOTAL 13 15 9 8 45 Table 2. “Pain at Worst in the past 24 hours” Category Shift between BL and month 5 in PP patients (n=37). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 13 2 0 0 15 Mild 4 7 1 1 13 Moderate 1 2 1 1 5 Severe 0 0 2 2 4 TOTAL 18 11 4 4 37

scholarly journals Effectiveness of Mobilizations along With Hot Therapy versus Mobilizations for Management of Chronic Neck Pain Due to Over Usage of Smart Phones among Young at LUMHS Jamshoro

2021 ◽  
pp. 57-62
Author(s):  
Jeetendar Valecha ◽  
Syed Mukhtar Ahmed ◽  
Tasghir Nabi ◽  
Mahesh Kumar Mugria ◽  
Siknader Ali Sangrasi ◽  
...  
Keyword(s):  
Neck Pain ◽  
Severe Pain ◽  
Chronic Neck Pain ◽  
Smart Phones ◽  
Moderate Pain ◽  
Mild Pain ◽  
Group A ◽  
Group B ◽  
Rehabilitation Sciences ◽  
Therapy Treatment

Objective: To determine the effectiveness of mobilizations along with hot therapy versus mobilizations for the management of chronic neck pain due to over usage of smart phones among young. Materials and Methods: This interventional clinical trial was conducted at OPD, Institute of Physiotherapy & Rehabilitation Sciences (IPRS) in Liaquat University Medical and Health Sciences Jamshoro (LUMHS). All the individuals from LUMHS Jamshoro including students, age 18-35 years and either of gender were included. All the individuals were divided in two groups (group A and group B). Cases of group A were underwent management of mobilization with hot therapy and cases of group B underwent only mobilization management. Outcome was observed in the terms of decrease the pain during work, reading and sleeping. All the data was recorded via study proforma. Results: Total 64 individuals were studied. Mean age was 26.2+4.2 years in group A and 28.6+5.3years. Males were in majority in both groups. According to the pain assessment on movement, mild pain was in 18.8%, moderate pain was 50.0%, severe pain was in 12.5% and very severe pain was in 18.85 of the patients of group A. However in group B most of the patients 93.8% had mild pain and 6.2% patients had severe pain, while no any patients with moderate pain and very severe pain was found in group B. After treatment pain was more decreased in patients of group A as pain during work, reading and sleeping was significantly higher in only mobilizations treatment group as compared to those underwent mobilizations with hot therapy treatment, p-values were quite significant. Conclusion: It was concluded that the treatment of mobilization with Hot pack was more effective than treatment only mobilization.

scholarly journals Frequency of plantar fasciitis due to improper shoes among different universities students

2021 ◽  
Vol 12 (1) ◽  
pp. 454-464
Author(s):  
Abdul wahid ◽  
Muhammad Arsalan Ali Sajid ◽  
Ambreen Muzaffar ◽  
Muhammad Zohaib Hussain
Keyword(s):  
Plantar Fasciitis ◽  
Severe Pain ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Moderate Pain ◽  
Cross Sectional ◽  
Mild Pain ◽  
Plantar Fasciopathy ◽  
Back Ground ◽  
Multiple Etiology

Back ground: study was conducted to determine the frequency of plantar fasciitis among three different universities students due to improper shoes. It was cross-sectional study. Plantar fasciitis is the inflammation of plantar fascia; plantar fascia is a thick connective tissue that forms the medial arch of foot. Improper shoes cause constant pressure and irritation on plantar fascia that leads to inflammation. When someone wears improper shoes, pronation activity of the foot decreased and it can lead to plantar fasciitis. Objective: The objective of study was to determine the frequency of plantar fasciitis due to improper shoes among three different universities students. Material and Methods: Study was cross-sectional and the data was collected from university students. Data was collected by using questionnaire and by applying statistical procedures results were concluded. Results: There were the following results in this study as, 35.5% participants without pain, 45% with mild pain, 16% with moderate pain and 3.6% with severe pain. There were 84% participants with single etiology, 13% participants with multiple etiology and 3% participants with nerve entrapment. There were 31 participants with no pain, 49 participants with mild pain, 11 participants with moderate pain and 2 participants with severe pain between ages 20-25 years. And between ages 26-30 there were 29 participants with no pain, 27 with mild pain, 16 with moderate pain and 4 participants with severe pain. Conclusion: Study concluded that 55.6% participants were between ages of 20-25 years. 54.4% participants were females, 59.2% participants were with no pain, 84% participants were with single etiology that is plantar fasciopathy. There were mostly participants suffered with mild pain and only 3.6% participants showed response with severe pain. There were mostly participants suffered with single etiology and the number of affected participants with plantar fasciitis slightly increased with age.

scholarly journals CHARACTERISTICS OF RENAL CANCER PATIENTS IN HAJI ADAM MALIK GENERAL HOSPITAL MEDAN IN THE YEAR 2011 -2015

2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Riyan Adi Kurnia ◽  
Dhirajaya Dharma Kadar ◽  
Fauriski Febrian Prapiska
Keyword(s):  
Mortality Rate ◽  
Cancer Patients ◽  
Kidney Cancer ◽  
Tnm Classification ◽  
Common Type ◽  
Histological Type ◽  
Treatment Modalities ◽  
Kidney Tumor ◽  
Female Ratio ◽  
Number Of Patients

Objective: The aim of this study is to identity the characteristics of kidney cancer patients at Haji Adam Malik Hospital between 2011 and 2015. Material & methods: This is a retrospective descriptive study of all kidney cancer patients treated at Haji Adam Malik Hospital between 2011 and 2015. Individual patient data was collected from medical record and compiled. Results: Between 2011 and 2015, there were 38 patients diagnosed with kidney cancer treated at Haji Adam Malik Hospital. The patients mean age is 48.26 ± 14.68 years, with a male to female ratio 1.7:1. Histological type found in the study was RCC (57.15%), urothelium based (19.05%), sarcoma variant (14.28%) and benign kidney tumor (9.52%). Clear cell RCC (58.3%) is the most common type of RCC. Based on the TNM classification, patients with kidney tumor of stage II, stage III and stage IV are 15.8%, 10.5% and 73.7% respectively. The treatment modalities for kidney cancer are nephrectomy (44.7%), nephroureterectomy (2.6%), biopsy (8.0%) and inoperable patients or treatment refusal (44.7%). The mortality rate of kidney cancer patients was 81.5%. Conclusion: Mean age of kidney cancer patients at Haji Adam Malik Hospital was lower than that reported in literature. Gender ratio was found similar as seen in literature. The ratio of histological type was differ, but we still found RCC as the most common type of kidney malignancies. Higher number of patients presented at advance stage at diagnosis and refusal to treatment may contribute to the high mortality rate in this study.

scholarly journals Efficacy and Safety of Intralesional Bleomycin in the Management of Ungual Warts

2020 ◽  
Vol 6 (6) ◽  
pp. 346-350
Author(s):  
Archana Singal ◽  
Chander Grover
Keyword(s):  
Medical Records ◽  
Complete Resolution ◽  
Severe Pain ◽  
Therapeutic Modality ◽  
Treatment Modalities ◽  
Moderate Pain ◽  
Efficacy And Safety ◽  
Nail Dystrophy ◽  
Lactating Women ◽  
Intralesional Injections

<b><i>Introduction:</i></b> Ungual warts are common fibroepithelial tumours of the nail unit caused by human papillomavirus. Although various treatment modalities are available, their management is challenging due to high potential for recurrence and treatment-related nail dystrophy. <b><i>Objective:</i></b> This study evaluates the efficacy and safety of intralesional bleomycin injections in the treatment of ungual warts. <b><i>Methods:</i></b> Medical records of 80 patients with ungual warts, treated by us from 2015 to 2019, were analysed retrospectively with respect to the number of warts, site, morphology, and treatment outcome. Children &#x3c;5 years of age, and pregnant and lactating women were excluded. All ungual warts were treated with intralesional injections of bleomycin 3 Units/mL, given at 3–4 weeks interval. <b><i>Results and Conclusions:</i></b> A total of 250 periungual and subungual warts were treated in 80 patients. An average of 2.61 sessions per patient was required for complete resolution. Moderate pain was reported by 65 patients (81.2%), and transitory perilesional hyperpigmentation was observed in 155 lesions (62%). Severe pain and necrosis developed in 3 lesions (1.2%) that were reversible without any residual scarring and deformity. We conclude that intralesional bleomycin is an effective and safe therapeutic modality for ungual warts.

scholarly journals ARTHROSCOPIC TREATMENT FOR LATERAL EPICONDYLITIS: OUTCOMES IN 104 CASES OF A SINGLE INSTITUTION

2019 ◽  
Vol 27 (3) ◽  
pp. 156-159
Author(s):  
Alexandre Tadeu do Nascimento ◽  
Gustavo Kogake Claudio ◽  
Pedro Bellei Rocha ◽  
Juan Pablo Zumárraga ◽  
Olavo Pires de Camargo
Keyword(s):  
Severe Pain ◽  
Short Form ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Lateral Epicondylitis ◽  
Dash Score ◽  
Moderate Pain ◽  
Duration Of Symptoms ◽  
Mild Pain ◽  
Sf 36

ABSTRACT Objective: To evaluate the outcomes of patients that underwent arthroscopic surgery for lateral epicondylitis (LE), after failed conservative treatment. Methods: One hundred four patients with LE treated with arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon were enrolled in this retrospective study. They were evaluated using Disabilities of the Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) and Short Form Health Survey (SF-36) scale. Mean age at surgery was 46.9 years. Duration of symptoms was 2.1 years (range: 6 m to 10 yrs.). Mean follow-up was 34.4 months (range: 6 to 68 m). Results: Mean postoperative scores were: 20.67 points on the DASH; 1.8 points on the VAS at rest, with 48 cases (46%) without pain, 40 (38%) with mild pain, 13 (13%) with moderate pain and 4 (4%) with severe pain; 4.7 points on the VAS in activity, with 21 (20%) without pain, 21 (20%) with mild pain, 35 (34%) with moderate pain and 27 (26%) with severe pain; and SF-36 was 66.8 points. Of the 23 patients who practiced sports regularly or with higher physical demand from the upper limbs, 17 (74%) were able to return to the same activity at the same level. No significant complications were observed postoperatively, except for 3 (2.8%) cases of postoperative superficial infection. Conclusion: Surgical treatment with arthroscopy for recalcitrant LE is effective and safe, presenting positive outcomes in the studied patients. Level of evidence IV, Case Series.

Pain assessment behavioral scale in agonic cancer patients: Experience in total care—An end-of-life care home service.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19636-e19636
Author(s):  
Maricarmen Alfaro ◽  
Raquel Baldeos ◽  
Beatriz Rosales ◽  
Maria Berenguel ◽  
Alfredo Aguilar
Keyword(s):  
Pain Score ◽  
Cancer Patients ◽  
Pain Assessment ◽  
Severe Pain ◽  
Care Home ◽  
Self Report ◽  
Moderate Pain ◽  
Primary Tumors ◽  
Mild Pain ◽  
Behavioral Scale

e19636 Background: Assessing pain in nonverbal, especially agonic cancer patients is a great challenge. In the absence of self-report, measurement of pain could be difficult and patient`s behavior could be useful. The aim of this work was to evaluate the Pain Assessment Behavioral Scale (PABS) in cancer agonic patients. Methods: PABS scale was used to evaluate 118 cancer patients enter in agony. Pain levels was categorized according to PABS score in Mild Pain (score 1-3), Moderate Pain (score 4-5), Severe Pain (score>6). We correlated levels of pain with age, sex, cancer metastatic site or active tumor localization with the ANOVA, Chi square or Fisher tests when were appropriated. A P<0.05 was considered significant. Results: Fifty two patients (44.1%) were male and 66 female (55.9%). The median age was 74 (Standar Deviation [SD]:13.1; Range: 30-94). Most frequent primary tumors were colorectal (16%), lung (11%), Pancreas (9.3%), Breast (8.5%), lymphomas (6.8%), prostate (6.8%) and gastric (5.6%) cancer. Involvement of primary active tumor or active metastases was present in lung (22%), Central Nervous System (CNS) (13.6%), liver (22%), and bone (7.6%). The median of PABS score was 5 (SD=1.25; range: 2 – 8). Seven cases had mild pain (5.9%), 105 moderate pain (89%) and 6 severe pain (5.1%). There was no correlation of pain levels with age (P=0.420), sex (P=0.098), active tumor or metastatic involvement of lung (P=0.321), CNS (P=0.972), Liver (P=0.575) or bone (P=0.529). Conclusions: In our experience, PABS scale is a useful tool to evaluate pain in agony cancer patients. We found no correlation between active tumor or metastatic localization with the intensity of pain.

scholarly journals FRI0396 HOW DOES OSTEOARTHRITIS PAIN IMPACT FUNCTION, MOBILITY AND REQUIREMENT FOR HELP IN DAILY ACTIVITIES IN EUROPEAN PATIENTS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 796.2-796
Author(s):  
P. G. Conaghan ◽  
L. Abraham ◽  
P. Graham-Clarke ◽  
L. Viktrup ◽  
J. C. Cappelleri ◽  
...  
Keyword(s):  
Physical Function ◽  
Functional Impairment ◽  
Severe Pain ◽  
Functional Limitations ◽  
Pain Severity ◽  
Daily Activities ◽  
Pharmacologic Therapy ◽  
Moderate Pain ◽  
Mild Pain ◽  
Impact Function

Background:Symptomatic osteoarthritis (OA) leads to functional limitations and loss of independence. OA management focuses on pain relief and preserving physical function using non-pharmacologic and pharmacologic therapy. Additionally, patients commonly manage OA pain by avoiding activities that exacerbate their pain. Informal care, i.e. assistance from an unpaid caregiver, plays a major role in the total care provided to patients with chronic diseases like OA.Objectives:To evaluate how OA pain severity affects physical functioning and the subsequent need for assistance with mobility and daily activities in 5 EU countries: France, Germany, Italy, Spain and UK.Methods:Data were drawn from the Adelphi OA Disease Specific Programme (2017-18), a point-in-time study of physicians and their OA patients. Patients rated their average pain intensity over the last week on a 0-10 scale (0 = no pain; 10 = worst possible pain) and were then categorised into mild (0-3), moderate (4-6) and severe (7-10) pain groups. Patients also provided an assessment of their physical function (0-10 WOMAC scale where higher scores indicated greater functional impairment), impact on mobility, whether caregiver assistance was required, daily activities requiring caregiver assistance and home modifications made due to their OA. Physicians also rated patients’ functioning on a 0 to 10 scale (0 = fully functional; 10 = completely impaired). Comparisons among pain severity groups were made using chi-squared tests and analysis of variance.Results:The analysis included 1750 OA patients: 24% mild pain (n=413); 47% moderate pain (n=822); 29% severe pain (n=515). The patients were predominantly women (58%) and had a mean (SD) age of 65.6 (11.5).Increased pain severity was associated with greater functional impairment scores as reported by patients (WOMAC scores: mild pain=2.1; moderate pain=4.1; severe pain=5.9) and physician-rated functional impairment (mild pain=3.5; moderate pain=4.3; severe pain=5.6). Mobility was impacted for 78% of patients with severe pain (vs. 41% mild; 63% moderate) and the need for a walking aid such as a walking stick or walking frame increased with worsening severity; wheelchair assistance was needed for 7% of severe patients (compared with <1% of mild or moderate patients). Furthermore, 31% of patients with severe pain reported having to modify their home due to their OA (vs. 11% mild; 18% moderate [p<0.001]), typically adapting their bathroom (23%) or fitting a stairlift (6%).The need for assistance from a caregiver to help with daily activities was associated with an increase in patients’ pain (9% mild; 20% moderate; 42% severe [p<0.001]). For most patients this was an immediate family member, however, the proportion of patients paying for professional care also increased with severity (1% mild; 2% moderate; 7% severe). Taking the patient to work or doctor’s appointments; help with shopping; preparing/cooking meals and help with travelling out of the home were most frequently reported activities needing caregiver assistance.Conclusion:In this study of European patients, increased pain severity was associated with greater functional impairment and impact on mobility as expected; however, this study highlights the substantial need for assistance with daily activities as well as modifications to the home. The unseen costs to the patient with moderate to severe OA pain are significant.Disclosure of Interests:Philip G Conaghan Consultant of: AbbVie, BMS, Eli Lilly, EMD Serono, Flexion Therapeutics, Galapagos, GSK, Novartis, Pfizer, Speakers bureau: AbbVie, Eli Lilly, Novartis, Pfizer, Lucy Abraham Shareholder of: Pfizer, Employee of: Pfizer, Peita Graham-Clarke Shareholder of: Eli Lilly and Co, Employee of: Eli Lilly and Co, Lars Viktrup Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Joseph C Cappelleri Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Craig Beck Shareholder of: Pfizer, Employee of: Pfizer, Andrew G Bushmakin Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Niall Hatchell: None declared, Emily Clayton: None declared, James Jackson: None declared

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