76 Chapter 4 DISCUSSION We demonstrated in this cross-sectional study that Achilles tendinopathy (AT) is associated with a low QoL score, specifically on the domains mobility, usual activities, and pain/ discomfort. Work absenteeism due to AT was low (reported in 9% of the patients), whereas more than one-third of the patients (38%) reported a reduction in work productivity due to AT. The total median annual number of healthcare visits was 9 and the total mean estimated annual direct and indirect costs are €840 (US $991) per AT patient. Quality of life The finding of a low QoL score in AT patients is in line with a recent exploratory study.11 The median EQ-VAS score in the current study was comparable to patients with chronic patellar tendinopathy (70 vs. 68 points).27 We also compared the score from the health-related QoL measure (EQ-5D) for AT to a large sample (n=3664) of the general Dutch population and different musculoskeletal diseases.16 Having Achilles tendinopathy was associated with a worse mean QoL score, compared to those without a musculoskeletal disease, on all EQ-5D dimensions, except for self-care. Patients with AT reported a similar, if not worse, QoL score on the domains mobility, usual activities and pain/discomfort, compared to those with other musculoskeletal diseases, such as rheumatoid arthritis, osteoarthritis, lateral epicondylar tendinopathy (tennis elbow) and fibromyalgia. Figure 1 depicts the differences in QoL domain scores between these diseases.16
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