Reasons Why Multimorbidity Increases the Risk of Participation Restriction in Older Adults With Lower Extremity Osteoarthritis: A Prospective Cohort Study in Primary Care

Wilkie, Ross; Blagojevic‐Bucknall, Milica; Jordan, Kelvin P.; Lacey, Rosie J.; McBeth, John

doi:10.1002/acr.21918

Cited by 36 publications

(31 citation statements)

References 44 publications

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“…It is also evident from the previous literature that individuals with osteoarthritis have at least two comorbid conditions and three-fourths of the individuals with osteoarthritis have three or more comorbid conditions. 16 The presence of Multimorbidity and depression among individuals with osteoarthritis can lead to increased pain and functional disability, 17 which in turn may contribute to excess healthcare expenditures among adults with osteoarthritis and depression compared to those with osteoarthritis and no depression.…”

Section: Introductionmentioning

confidence: 99%

Healthcare Expenditures Associated with Depression Among Individuals with Osteoarthritis: Post-Regression Linear Decomposition Approach

Agarwal

Sambamoorthi

2015

J GEN INTERN MED

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BACKGROUND: Depression is common among individuals with osteoarthritis and leads to increased healthcare burden. The objective of this study was to examine excess total healthcare expenditures associated with depression among individuals with osteoarthritis in the US. DESIGN: Adults with self-reported osteoarthritis (n= 1881) were identified using data from the 2010 Medical Expenditure Panel Survey (MEPS). Among those with osteoarthritis, chi-square tests and ordinary least square regressions (OLS) were used to examine differences in healthcare expenditures between those with and without depression. Post-regression linear decomposition technique was used to estimate the relative contribution of different constructs of the Anderson's behavioral model, i.e., predisposing, enabling, need, personal healthcare practices, and external environment factors, to the excess expenditures associated with depression among individuals with osteoarthritis. All analysis accounted for the complex survey design of MEPS. KEY RESULTS: Depression coexisted among 20.6 % of adults with osteoarthritis. The average total healthcare expenditures were $13,684 among adults with depression compared to $9284 among those without depression. Multivariable OLS regression revealed that adults with depression had 38.8 % higher healthcare expenditures (p<0.001) compared to those without depression. Postregression linear decomposition analysis indicated that 50 % of differences in expenditures among adults with and without depression can be explained by differences in need factors. CONCLUSIONS: Among individuals with coexisting osteoarthritis and depression, excess healthcare expenditures associated with depression were mainly due to comorbid anxiety, chronic conditions and poor health status. These expenditures may potentially be reduced by providing timely intervention for need factors or by providing care under a collaborative care model.

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Section: Introductionmentioning

confidence: 99%

Healthcare Expenditures Associated with Depression Among Individuals with Osteoarthritis: Post-Regression Linear Decomposition Approach

Agarwal

Sambamoorthi

2015

J GEN INTERN MED

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“…We have previously reported on the frequency and individual risk factors for the onset of any form of participation restriction in all older people in the general population [20, 21]. This paper explores both individual and area-level contextual socioeconomic factors that predict the onset of work restriction in those with lower limb osteoarthritis who remain in work.…”

Section: Introductionmentioning

confidence: 99%

Onset of Work Restriction in Employed Adults with Lower Limb Joint Pain: Individual Factors and Area-Level Socioeconomic Conditions

et al. 2013

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Purpose To examine individual and area-level socioeconomic factors that predict the onset of work restriction in employed persons with lower limb joint pain. Methods Population-based prospective cohort study. Adults were aged 50–59, reported hip, knee, foot pain or a combination and maintained employment through 3 year follow-up (n = 716). Work restriction was measured as inability to participate in work as desired. Multi-level logistic regression was used to assess the associations of work restriction onset with baseline factors: health (severity of knee pain/functional limitation, comorbidity, anxiety, depression, cognitive impairment, abnormal weight), demographic socio-economic, environment and area-level employment deprivation. Results 108 (15.1 %) reported the onset of work restriction over 3 years. Severe lower limb joint pain and functional limitation, number of affected body sites and area employment deprivation were independently associated with onset. Significant interactions indicated a greater effect of area employment deprivation on older and more depressed workers. Conclusions Results suggest that effectively preventing work disability in those with OA will require both condition-specific interventions to decrease pain and maintain function, and providing alternative employment opportunities for those with progressive functional limitations. Results in older workers are particularly concerning, as retirement ages are expected to increase in the general population.

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“…13 The combination of obesity and pain worsens HRQL more substantially than either condition alone; the HRQL and family and local lives of obese subjects are affected; and higher BMI corresponds to worse impairment and worse pain. 11,14 Chronic pain increases the already huge societal burden of obesity in terms of Social Security and the financial burden of disability and health care costs. 15 In addition to final organ damage, the increase in fat mass of obese individuals facilitates the development of a range of incapacitating musculoskeletal conditions.…”

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confidence: 99%

Obesity and Chronic Pain

Narouze

Souzdalnitski

2015

Regional Anesthesia and Pain Medicine

114

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The combination of obesity and pain may worsen a patient's functional status and quality of life more than each condition in isolation. We systematically searched PubMed/MEDLINE and the Cochrane databases for all reports published on obesity and pain. The prevalence of combined obesity and pain was substantial. Good evidence shows that weight reduction can alleviate pain and diminish pain-related functional impairment. However, inadequate pain control can be a barrier to effective lifestyle modification and rehabilitation. This article examines specific pain management approaches for obese patients and reviews novel interventional techniques for treatment of obesity. The infrastructure for simultaneous treatment of obesity and pain already exists in pain medicine (eg, patient education, behavioral medicine approaches, physical rehabilitation, medications, and interventional treatment). Screening for obesity, pain-related disability, and behavioral disorders as well as monitoring of functional performance should become routine in pain medicine practices. Such an approach requires additional physician and staff training. Further research should focus on better understanding the interplay between these 2 very common conditions and the development of effective treatment strategies.

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Reasons Why Multimorbidity Increases the Risk of Participation Restriction in Older Adults With Lower Extremity Osteoarthritis: A Prospective Cohort Study in Primary Care

Cited by 36 publications

References 44 publications

Healthcare Expenditures Associated with Depression Among Individuals with Osteoarthritis: Post-Regression Linear Decomposition Approach

Healthcare Expenditures Associated with Depression Among Individuals with Osteoarthritis: Post-Regression Linear Decomposition Approach

Onset of Work Restriction in Employed Adults with Lower Limb Joint Pain: Individual Factors and Area-Level Socioeconomic Conditions

Obesity and Chronic Pain

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