9 161 General discussion Figure 1. Comparison of the EQ-5D scores for Achilles tendinopathy patients with patients post myocardial infarction18, patients with chronic heart failure19, colorectal cancer16 and prostate cancer17. Displayed values are percent with any (moderate and severe) problems. EQ-5D: EuroQoL five-item questionnaire for measuring health-related quality of life. It is important to acknowledge that the conditions mentioned earlier typically have significantly more profound and far-reaching consequences than Achilles tendinopathy. Nevertheless, this comparison shows how individuals with Achilles tendinopathy experience a profound impact on their quality of life. If policymakers continue to focus on outcomes such as morbidity and mortality and less on quality of life, they will not adequately serve the population. These data should lead to a shift towards research on more effective treatments for musculoskeletal disorders and tendinopathies specifically. Two qualitative studies highlight the psychosocial impact of Achilles tendinopathy, with patients stating: ‘’I no longer feel like I’m in control’’, ‘’Wanting to run and I’m stuck here. Now I know there are worse things in life that can happen, but it’s been horrible’’ and ‘’I feel like there is nothing at the end of the tunnel’’.20,21 While our knowledge of Achilles tendinopathy is advancing, the existing body of research in the field is dominated by a focus on functional and disability-related outcome measures at the expense of psychosocial ones.22 The predominant focus on these outcome measures does not support the concept of a more patient-centred approach in the management of Achilles tendinopathy. We recommend that clinicians and researchers integrate psychosocial factors into the evaluation and treatment of Achilles tendinopathy patients. This may not only improve the management of Achilles tendinopathy but may also promote greater adherence to evidence-based interventions such as exercise therapy.23,24 It is
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