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Clinical Rheumatology

, Volume 34, Issue 8, pp 1435–1441 | Cite as

The association of comorbid conditions with patient-reported outcomes in Veterans with hip and knee osteoarthritis

  • Leah L. Zullig
  • Hayden B. Bosworth
  • Amy S. Jeffreys
  • Leonor Corsino
  • Cynthia J. Coffman
  • Eugene Z. Oddone
  • William S. YancyJr.
  • Kelli D. AllenEmail author
Original Article

Abstract

There is limited understanding of how comorbid health conditions affect osteoarthritis (OA)-related outcomes. This study examined associations of different comorbidity measures with baseline OA-related patient-reported outcomes (PROs) among patients with hip and knee OA. Data were from patients (N = 300, 9 % female, mean age = 61.1; SD = 9.2) enrolled in a randomized control trial at the Durham Veterans Affairs Medical Center. Separate multivariable regression models, adjusted for demographic and clinical characteristics, examined the association of each comorbidity measure with baseline PROs: pain, physical function, depressive symptoms, fatigue, and insomnia. Comorbidity measures included the Self-Administered Comorbidity Questionnaire (SACQ), conditions reported as activity-limiting (SACQ-AL), and indicators of depression, diabetes, hypertension, and back pain. Mean (SD) numbers of comorbid conditions and activity-limiting conditions were 3.4 (1.8) and 1.6 (1.4), respectively. Comorbidity scores (SACQ overall and SACQ-AL) and individual comorbidity conditions were each associated with worse OA-related PROs adjusting for demographic and clinical factors. Worse SACQ overall and SACQ-AL scores were associated with worse mean scores for pain, depressive symptoms, fatigue, and insomnia (p values <0.01). Additionally, increasing SACQ-AL scores were associated with worse mean scores for function (p < 0.01). Depression was associated with worse pain (p = 0.03), fatigue, and insomnia (p values <0.01). Diabetes was associated with worse fatigue (p = 0.01), depressive symptoms (p = 0.02), and insomnia (p = 0.03). Back pain was associated with worse pain scores (p = 0.02). Results provide evidence that comorbidity burden, particularly activity-limiting conditions, is associated with worse OA-related PROs. Interventions for patients with OA need to address comorbid conditions and their impact on key outcomes.

Keywords

Chronic disease Comorbidity Osteoarthritis United States Department of Veterans Affairs 

Notes

Disclosures

None.

Funding

This project was supported by the National Institute of Arthritis and Musculoskeletal and Skin Disorders (1R01AR059673-01) and the Department of Veterans Affairs, Health Services Research and Development Service (IIR 10–126).

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Copyright information

© Clinical Rheumatology 2014

Authors and Affiliations

  • Leah L. Zullig
    • 1
    • 2
  • Hayden B. Bosworth
    • 1
    • 2
    • 3
    • 4
  • Amy S. Jeffreys
    • 1
  • Leonor Corsino
    • 5
  • Cynthia J. Coffman
    • 1
    • 6
  • Eugene Z. Oddone
    • 1
    • 2
  • William S. YancyJr.
    • 1
    • 2
  • Kelli D. Allen
    • 1
    • 7
    • 8
    Email author
  1. 1.Center for Health Services Research in Primary CareDurham Veterans Affairs Medical CenterDurhamUSA
  2. 2.Division of General Internal Medicine, Department of MedicineDuke UniversityDurhamUSA
  3. 3.School of NursingDuke UniversityDurhamUSA
  4. 4.Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamUSA
  5. 5.Division of Endocrinology, Department of MedicineDuke UniversityDurhamUSA
  6. 6.Biostatistics and BioinformaticsDuke UniversityDurhamUSA
  7. 7.Division of Rheumatology, Department of MedicineUniversity of North CarolinaChapel HillUSA
  8. 8.Thurston Arthritis Research CenterUniversity of North CarolinaChapel HillUSA

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