68 Chapter 4 ABSTRACT Objectives: To evaluate the impact of Achilles tendinopathy (AT) on quality of life (QoL), work performance, healthcare utilization and costs in adults with conservatively-treated chronic midportion AT Methods: This cross-sectional survey-based study included 80 patients and took place in a sports medicine department of a large regional hospital in the Netherlands. Data were collected before any intervention was given. Primary outcome was the EuroQol questionnaire (EQ-5D). The EQ-5D expresses the percentage of moderate/major problems on the domains self-care, anxiety/depression, mobility, usual activities and pain/ discomfort. Secondary outcomes were the number of previous healthcare visits, work performance during the period of symptoms and estimated annual direct medical and indirect costs per patient as result of AT. Results: All 80 patients completed the questionnaires. The EQ-5D scores were low for the domains self-care (1%) and anxiety/depression (20%), and high for the domains mobility (66%), usual activities (50%), and pain/discomfort (89%). Patients with AT mainly reported an impact on work productivity (38%). Work absenteeism due to AT was present in 9%. The total median (IQR) number of annual healthcare visits was 9 (3-11). The total mean (SD) estimated annual costs were €840 (1420) per AT patient (mean and SD US $991 (1675)). Conclusions: This study shows the large impact of Achilles tendinopathy on QoL and work productivity. This study also provides new information about the socio-economic impact of AT, which emphasizes that this common and longstanding disease causes substantial costs. These findings stress the need for optimized treatment and improved preventive interventions for AT.
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