Frequency of comorbidities in patients with osteoarthritis and their impact on pain and physical function

Mohammed Taherul Islam; Mohammad Imtiaz Sultan; Aparna Deb; Protyay Dey; M. Saiful Arif; Anupam Barua; Muhammad Habib Hassan; Shamshed Nesreen Romana; Tousif Bin Mamun; Simanto

doi:10.18203/2320-6012.ijrms20260813

Authors

Mohammed Taherul Islam Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh
Mohammad Imtiaz Sultan Department of Rheumatology, Kurmitola General Hospital, Dhaka, Bangladesh
Aparna Deb Department of Medicine, Upazila Health Complex, Fatikchari, Chittagong, Bangladesh
Protyay Dey Department of Nephrology, Chittagong Medical College, Chittagong, Bangladesh
M. Saiful Arif Department of Rheumatology, Chittagong Medical College, Chittagong, Bangladesh
Anupam Barua Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh
Muhammad Habib Hassan Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh
Shamshed Nesreen Romana Department of Radiology and Imaging, Chittagong Medical College Hospital, Chittagong, Bangladesh
Tousif Bin Mamun Department of ENT, Chittagong General Hospital, Chittagong, Bangladesh
Simanto Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20260813

Keywords:

Osteoarthritis, Knee osteoarthritis, Comorbidity, Hypertension, Diabetes mellitus

Abstract

Background: Osteoarthritis (OA) is one of the commonest morbidities in older age population and the most common reason for restricted activity in their daily life. The prevalence of other disabling condition also rises with age and some common chronic condition can be found along with OA. The aim of this study was to identify frequency of comorbidities in patients with OA and impact of comorbidities on pain and physical function of the patients.

Methods: Self-reported comorbidities, clinical examinations and relevant investigations findings were recorded in a case record form. Depression and anxiety were measured by PHQ-9 and GAD-7 scale respectively. Pain of joint and physical function was measured by WOMAC questionnaire.

Results: The mean of the age, BMI (body mass index) and duration of pain was respectively 56.83 (±8.28) years, 26.01 (±4.1) kg/m² and 4.1 (±2.9) years. Male female ratio was 1:2.23. About one fifth of the patients (19.1%) reported no associated comorbid conditions and approximately three fourth of patients (70%) reported one or two comorbid conditions and another 11% reported three or more comorbid conditions. Of the comorbid conditions the most frequent was HTN (45.5%), followed by DM (20.9%), depression (20.9%) and anxiety (13.6%). The mean pain and physical function scores were 17.8±7.1 and 63.6±21.7 respectively.

Conclusions: In summary, the OA patients showed a high frequency of comorbid conditions including depression, which can impact the pain and physical function of those patients. Such results show the need for investigating and treating those comorbidities in OA patients.

Metrics

Metrics Loading ...

References

Lane NE, Brandt K, Hawker G, Peeva E, Schreyer E, Tsuji W, Hochberg MC. OARSI-FDA initiative: defining the disease state of osteoarthritis. Osteoarthritis Cartilage. 2011;19(5):478-82. DOI: https://doi.org/10.1016/j.joca.2010.09.013

Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, Dragomir A, Kalsbeek WD, Luta G, Jordan JM. Lifetime risk of symptomatic knee osteoarthritis. Arthritis Rheum. 2008;59(9):1207-13. DOI: https://doi.org/10.1002/art.24021

Nguyen US, Zhang Y, Zhu Y, Niu J, Zhang B, Felson DT. Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data. Ann Intern Med. 2011;155(11):725-32. DOI: https://doi.org/10.7326/0003-4819-155-11-201112060-00004

Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2163-96. DOI: https://doi.org/10.1016/S0140-6736(12)61729-2

Haq SA, Darmawan J, Islam MN, Uddin MZ, Das BB, Rahman F, et al. Prevalence of rheumatic diseases and associated outcomes in rural and urban communities in Bangladesh: a COPCORD study. J Rheumatol. 2005;32(2):348-53.

Litwic A, Edwards MH, Dennison EM, Cooper C. Epidemiology and burden of osteoarthritis. Br Med Bull. 2013;105:185-99. DOI: https://doi.org/10.1093/bmb/lds038

Holla JF, van der Leeden M, Knol DL, Roorda LD, van der Esch M, Voorneman RE, et al. The association of body-mass index and depressed mood with knee pain and activity limitations in knee osteoarthritis: results from the Amsterdam osteoarthritis cohort. BMC Musculoskelet Disord. 2013;14(1):296. DOI: https://doi.org/10.1186/1471-2474-14-296

Singh JA, Lewallen DG. Time trends in the characteristics of patients undergoing primary total knee arthroplasty. Arthritis Care Res. 2013;66(6):897-906. DOI: https://doi.org/10.1002/acr.22233

Perruccio AV, Katz JN, Losina E. Health burden in chronic disease: multimorbidity is associated with self-rated health more than medical comorbidity alone. J Clin Epidemiol. 2012; 65(1):100-6. DOI: https://doi.org/10.1016/j.jclinepi.2011.04.013

Cleveland RJ, Luong ML, Knight JB, Schoster B, Renner JB, Jordan JM, et al. Independent associations of socioeconomic factors with disability and pain in adults with knee osteoarthritis. BMC Musculoskelet Disord. 2013;14(1):297. DOI: https://doi.org/10.1186/1471-2474-14-297

Dekker J, van Dijk GM, Veenhof C. Risk factors for functional decline in osteoarthritis of the hip or knee. Curr Opin Rheumatol. 2009;21(5):520-4. DOI: https://doi.org/10.1097/BOR.0b013e32832e6eaa

Garver MJ, Focht BC, Dials J, Rose M, Lucas AR, Devor ST, et al. Weight status and differences in mobility performance, pain symptoms, and physical activity in older, knee osteoarthritis patients. Arthritis 2014;2014:375909. DOI: https://doi.org/10.1155/2014/375909

Palazzo C, Nguyen C, Lefevre-Colau M M, Rannou F, Poiraudeau S. Risk factors and burden of osteoarthritis. Ann Physical Rehabilitation Med. 2016;59(3):134-8. DOI: https://doi.org/10.1016/j.rehab.2016.01.006

Rayner L, Hotopf M, Petkova H, Matcham F, Simpson A, McCracken LM. Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs. Pain. 2016;157(7):1472-9. DOI: https://doi.org/10.1097/j.pain.0000000000000542

McKevitt S, Healey E, Jinks C, Rathod-Mistry T, Quicke J. The association between comorbidity and physical activity levels in people with osteoarthritis: Secondary analysis from two randomised controlled trials. Osteoarthritis Cartilage Open. 2020;2(2):100057. DOI: https://doi.org/10.1016/j.ocarto.2020.100057

Ahmed SM, Emran M, Hasan MI, Newaz F, Ahmed B, Khandaker MN, et al. Correlation of Pain, Physical Function and Radiography with Osteoarthritis of the knee. KYAMC J. 2020;10(4):173-8. DOI: https://doi.org/10.3329/kyamcj.v10i4.45714

Birtwhistle R, Morkem R, Peat G, Williamson T, Green ME, Khan S, Jordan KP. Prevalence and management of osteoarthritis in primary care: an epidemiologic cohort study from the Canadian Primary Care Sentinel Surveillance Network. CMAJ Open. 2015;3(3):E270-5. DOI: https://doi.org/10.9778/cmajo.20150018

Shakoor MA, Taslim MA, Ahmed MS, Hasan SA. Clinical Profile of Patients with Osteoarthritis of the Knee: A Study of 162 Cases. Int J Physical Med Rehabilitation. 2009;20(2):44-7.

Swain S, Choudhury P. Comorbidity and healthcare utilization in osteoarthritis; a primary care survey from Odisha, India. Clin Epidemiol Global Health. 2019;7(4):661-7. DOI: https://doi.org/10.1016/j.cegh.2019.03.002

Swain S, Sarmanova A, Coupland C, Doherty M, Zhang W. Comorbidities in Osteoarthritis: A systematic review and metaanalysis of observational studies. Arthritis Care Res. 2020;72(7):991-1000. DOI: https://doi.org/10.1002/acr.24008

Sharma A, Kudesia P, Shi Q, Gandhi R. Anxiety and depression in patients with osteoarthritis: impact and management challenges. Open Access Rheumatol. 2016;8:103-13. DOI: https://doi.org/10.2147/OARRR.S93516

Leite AA, Costa AJ, Lima Bde A, Padilha AV, Albuquerque EC, Marques CD. Comorbidities in patients with osteoarthritis: frequency and impact on pain and physical function. Rev Bras Reumatol. 2011;51(2):118-23. DOI: https://doi.org/10.1590/S0482-50042011000200002