Work Productivity and Activity Impairment in Osteoarthritis Patients Receiving Etoricoxib versus Diclofenac: A Prospective Observational Study

Authors

  • Adi Nurmesa Departemen Farmakologi dan Farmasi Klinik Universitas Padjadjaran Author

DOI:

https://doi.org/10.65745/soj.v1.i2.16

Keywords:

WPAI-OA, Quality of Life , Etoricoxib, Diclofenac sodium

Abstract

Osteoarthritis (OA) is a common musculoskeletal condition that adversely affects work productivity and daily activities. This study aimed to assess the convergent validity and test–retest reliability of the Indonesian version of the Work Productivity and Activity Impairment Questionnaire for Osteoarthritis (WPAI-OA) and compare productivity-related outcomes between patients receiving etoricoxib and diclofenac sodium. A prospective observational study was conducted involving 30 outpatients with OA at three tertiary hospitals in Indonesia between January 2023 and March 2024. Participants completed the WPAI-OA and EQ-5D-5L questionnaires at baseline and one week later. Convergent validity was assessed using Spearman's correlation coefficients, while test–retest reliability was evaluated among clinically stable participants. The WPAI-OA demonstrated moderate to strong correlations with EQ-5D-5L scores (|r| = 0.570–0.694), supporting its convergent validity. Test–retest correlations across questionnaire domains ranged from 0.385 to 0.694. Patients receiving etoricoxib reported lower work time missed (4.80% vs. 7.59%) and overall work impairment (20.49% vs. 23.09%) than those receiving diclofenac sodium. These findings provide preliminary evidence supporting the convergent validity and reproducibility of the Indonesian WPAI-OA in patients with OA. Although differences in productivity outcomes were observed between treatment groups, the small sample size and observational design limit causal interpretation. Further studies with larger samples are warranted to confirm the instrument's measurement properties and explore treatment-related differences.

References

Bilbao, A., García-Pérez, L., Arenaza, J. C., García, I., Ariza-Cardiel, G., Trujillo-Martín, E., Forjaz, M. J., & Martín-Fernández, J. (2018). Psychometric properties of the EQ-5D-5L in patients with hip or knee osteoarthritis: Reliability, validity and responsiveness. Quality of Life Research, 27(11), 2897–2908. https://doi.org/10.1007/s11136-018-1929-x

da Costa, B. R., Pereira, T. V., Saadat, P., Rudnicki, M., Iskander, S. M., Bodmer, N. S., Bobos, P., Gao, L., Kiyomoto, H. D., Montezuma, T., Almeida, M. O., Cheng, P.-S., Hincapié, C. A., Hari, R., Sutton, A. J., Tugwell, P., Hawker, G. A., & Jüni, P. (2021). Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: Network meta-analysis. BMJ, 375, n2321. https://doi.org/10.1136/bmj.n2321

GBD 2021 Osteoarthritis Collaborators. (2023). Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet Rheumatology, 5(9), e508–e522. https://doi.org/10.1016/S2665-9913(23)00163-7

Kiadaliri, A., Cronström, A., Dahlberg, L. E., & Lohmander, L. S. (2024). Patient acceptable symptom state and treatment failure threshold values for work productivity and activity impairment and EQ-5D-5L in osteoarthritis. Quality of Life Research, 33(5), 1257–1266. https://doi.org/10.1007/s11136-024-03602-6

Litwic, A., Edwards, M. H., Dennison, E. M., & Cooper, C. (2013). Epidemiology and burden of osteoarthritis. British Medical Bulletin, 105(1), 185–199. https://doi.org/10.1093/bmb/lds038

Long, H., Liu, Q., Yin, H., Wang, K., Diao, N., Zhang, Y., Lin, J., & Guo, A. (2022). Prevalence trends of site-specific osteoarthritis from 1990 to 2019: Findings from the Global Burden of Disease Study 2019. Arthritis & Rheumatology, 74(7), 1172–1183. https://doi.org/10.1002/art.42089

Nakata, K., Tsuji, T., Vietri, J., & Jaffe, D. H. (2018). Work impairment, osteoarthritis, and health-related quality of life among employees in Japan. Health and Quality of Life Outcomes, 16, Article 64. https://doi.org/10.1186/s12955-018-0896-9

Nurmesa, A., Jannah, W., & Rachman, A. (2024). Risk factors and pharmacist intervention to reduce the incidence of overdose of etoricoxib drug in outpatient polyclinic patients. Journal of Advanced Pharmacy Research, 8(4), 225–230. https://doi.org/10.21608/aprh.2024.290525.1270

Nurmesa, A., Jannah, W., Rachman, A., & Wahyudi. (2024). Risk factors for duplication of NSAIDs without gastroprotective in one of the hospitals in Indonesia. Medical Sains: Jurnal Ilmiah Kefarmasian, 9(3), 757–764. https://doi.org/10.37874/ms.v9i3.1271

Nurmesa, A., Rachman, A., & Jannah, W. (2024). Overview prescribing with duplicated NSAID therapy without gastric protective agents at a hospital in Indonesia. Jurnal Ilmiah Farmako Bahari, 15(2), 121–126. https://doi.org/10.52434/jifb.v15i2.3179

Nurmesa, A., Zakiyah, N., & Insani, W. N. (2025). Clinical presentations and characteristics of NSAIDs hypersensitivity in a tertiary care hospital in Indonesia: A case series. International Medical Case Reports Journal, 18, 163–171. https://doi.org/10.2147/IMCRJ.S488796

Reilly, M. C., Gooch, K. L., Wong, R. L., Kupper, H., & van der Heijde, D. (2010). Validity, reliability and responsiveness of the Work Productivity and Activity Impairment Questionnaire in ankylosing spondylitis. Rheumatology, 49(4), 812–819. https://doi.org/10.1093/rheumatology/kep457

Revicki, D., Hays, R. D., Cella, D., & Sloan, J. (2008). Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. Journal of Clinical Epidemiology, 61(2), 102–109. https://doi.org/10.1016/j.jclinepi.2007.03.012

Walker, C. (2018). Are all oral COX-2 selective inhibitors the same? A consideration of celecoxib, etoricoxib, and diclofenac. International Journal of Rheumatology, 2018, Article 1302835. https://doi.org/10.1155/2018/1302835

Zhang, Y., Wang, Y., Zhao, C., Cai, W., Wang, Z., & Zhao, W. (2023). Effects of blood pressure and antihypertensive drugs on osteoarthritis: A mendelian randomized study. Aging Clinical and Experimental Research, 35(11), 2437–2444. https://doi.org/10.1007/s40520-023-02530-8

Published

2026-11-02

Issue

Vol. 1 No. 2 (2026)

Section

Articles

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Copyright (c) 2026 Adi Nurmesa (Author)

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How to Cite

Nurmesa, A. (2026). Work Productivity and Activity Impairment in Osteoarthritis Patients Receiving Etoricoxib versus Diclofenac: A Prospective Observational Study. Soeharso Orthopaedic Journal, 1(2). https://doi.org/10.65745/soj.v1.i2.16