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

Zullig LL, Bosworth HB, Jeffreys AS, Corsino L, Coffman CJ, Oddone EZ, Yancy WS, Allen KD. The association of comorbid conditions with patient-reported outcomes in Veterans with hip and knee osteoarthritis. Clinical Rheumatology. 2015 Aug 1; 34(8):1435-41.

Related HSR&D Project(s)

• CDA 13-025 – Colorectal Cancer Survivorship Care in the Veterans Affairs Healthcare System
• IIR 10-126 – Patient and Provider Interventions for Managing Osteoarthritis in Primary Care

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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.