80 Chapter 4 CONCLUSION We demonstrated the large impact of Achilles tendinopathy on quality of life, specifically on the domains mobility, pain/discomfort, and usual activities. The magnitude of this impact seems similar to other chronic musculoskeletal conditions, such as knee osteoarthritis and rheumatoid arthritis. AT impacts significantly on work, with more than one third of patients having decreased work productivity. Healthcare utilization, direct and indirect costs as a result of AT are substantial with a total mean estimated annual direct and indirect costs of €840 per AT patient. These costs seem similar to other chronic musculoskeletal conditions. The above mentioned socio-economic impact of AT stresses the need for optimized treatment and improved preventive measures. SUPPLEMENTARY MATERIAL All supplementary material is available online at: https://bmjopensem.bmj.com/ content/7/1/e001023
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