Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May 14:10:2235042X20920456.
doi: 10.1177/2235042X20920456. eCollection 2020 Jan-Dec.

Comorbidities and their link with individual health status: A cross-sectional analysis of 23,892 people with knee and hip osteoarthritis from primary care

Paul Edward Muckelt  1   2 , E M Roos  3 , M Stokes  1   2 , S McDonough  4   5   6 , D T Grønne  3 , S Ewings  1 , S T Skou  3   7
Affiliations

Comorbidities and their link with individual health status: A cross-sectional analysis of 23,892 people with knee and hip osteoarthritis from primary care

Paul Edward Muckelt et al. J Comorb. .

Abstract

Objectives: Robust data on the impact of comorbidities on health in people with osteoarthritis (OA) are lacking, despite its potential importance for patient management. Objectives were to determine coexisting conditions in people with OA in primary care and whether more comorbidities were linked with individual health status.

Methods: A retrospective analysis of 23,892 patients with knee and hip OA was conducted to determine comorbidities present (number/clusters) and how these linked with pain intensity (0-100), widespread pain (site numbers), medication usage (paracetamol, nonsteroidal anti-inflammatory drugs, opioids), quality of life EuroQol five dimension scale (EQ-5D), and physical function (walking speed) using independent t-tests or χ 2 test.

Results: Sixty-two percent of people with OA treated in primary care had at least one comorbidity; hypertension (37%), heart disease (8%), and diabetes (7%) being most common. Outcome measures worsened with more comorbidities (0-4+ comorbidities); pain intensity [mean (SD)] 46(22)-57(21); number of painful sites 3.7(3.0)-6.3(5.4); quality of life 0.73(0.10)-0.63(0.15); walking speed 1.57 m/s (0.33)-1.24 m/s (0.31), while the proportion of people using pain medication increased from 0 to 2 comorbidities (58-69%; p < 0.001), with an increase in opioid use from 4.6% to 19.5% with more comorbidities (0-4+ comorbidities).

Conclusion: Most people with knee or hip OA in primary care have at least one other long-term condition. A greater number of comorbidities is linked with worsening health, highlighting the importance of screening for comorbidities when treating patients with OA. It is important for clinicians to consider how OA treatments will interact and affect other common comorbidities.

Keywords: Osteoarthritis; comorbidity; health status; multimorbidity.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: EMR is the deputy editor of Osteoarthritis and Cartilage, the developer of the Knee injury and Osteoarthritis Outcome Score (KOOS) and several other freely available patient-reported outcome measures, and cofounder of Good Life with Osteoarthritis in Denmark (GLA: D®), a not-for-profit initiative hosted at the University of Southern Denmark aimed at implementing clinical guidelines for OA in clinical practice. STS, an associate editor of the Journal of Orthopaedic & Sports Physical Therapy, has received grants from The Lundbeck Foundation, personal fees from Munksgaard, all of which are outside the submitted work. He is the cofounder of GLA: D®.

Figures

Figure 1.
Figure 1.
Percentage of patients with osteoarthritis presenting with each other condition. Miscellaneous medical conditions were defined as any conditions other than those mentioned previously.
See this image and copyright information in PMC

References

    1. Farmer C, Fenu E, O’Flynn N, et al. Clinical assessment and management of multimorbidity: summary of NICE guidance. BMJ 2016; 354: 4843. - PubMed
    1. Valderas JM, Starfield B, Sibbald B, et al. Defining comorbidity: implications for understanding health and health services. Ann Fam Med 2009; 7(4): 357–363. - PMC - PubMed
    1. Arokiasamy P, Uttamacharya U, Jain K, et al. The impact of multimorbidity on adult physical and mental health in low-and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal? BMC Med 2015; 13(1): 178. - PMC - PubMed
    1. Barnett K, Mercer SW, Norbury M, et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012; 380(9836): 37–43. - PubMed
    1. Salisbury C, Johnson L, Purdy S, et al. Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study. Br J Gen Pract 2011; 61(582): e12–e21. - PMC - PubMed

LinkOut - more resources