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Public health
Original research
Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada
  1. Deborah A Marshall1,2,3,4,
  2. Xiaoxiao Liu1,3,4,
  3. Cheryl Barnabe1,2,
  4. Karen Yee5,
  5. Peter D Faris5,
  6. Claire Barber1,2,
  7. Dianne Mosher2,
  8. Thomas Noseworthy1,
  9. Jason Werle6,
  10. Lisa Lix7
  1. 1 Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
  2. 2 Department of Medicine, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
  3. 3 McCaig Bone and Joint Health Institute, Calgary, Alberta, Canada
  4. 4 O'Brien Institute for Public Health, Calgary, Alberta, Canada
  5. 5 Research Facilitation, Alberta Health Services, Calgary, Alberta, Canada
  6. 6 Department of Surgery, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  7. 7 Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
  1. Correspondence to Dr Deborah A Marshall; damarsha{at}ucalgary.ca

Abstract

Objectives The purpose of this study is to estimate the prevalence of comorbidities among people with osteoarthritis (OA) using administrative health data.

Design Retrospective cohort analysis.

Setting All residents in the province of Alberta, Canada registered with the Alberta Health Care Insurance Plan population registry.

Participants 497 362 people with OA as defined by ‘having at least one OA-related hospitalization, or at least two OA-related physician visits or two ambulatory care visits within two years’.

Primary outcome measures We selected eight comorbidities based on literature review, clinical consultation and the availability of validated case definitions to estimate their frequencies at the time of diagnosis of OA. Sex-stratified age-standardised prevalence rates per 1000 population of eight clinically relevant comorbidities were calculated using direct standardisation with 95% CIs. We applied χ2 tests of independence with a Bonferroni correction to compare the percentage of comorbid conditions in each age group.

Results 54.6% (n=2 71 794) of people meeting the OA case definition had at least one of the eight selected comorbidities. Females had a significantly higher rate of comorbidities compared with males (standardised rates ratio=1.26, 95% CI 1.25 to 1.28). Depression, chronic obstructive pulmonary disease (COPD) and hypertension were the most prevalent in both females and males after age-standardisation, with 40% of all cases having any combination of these comorbidities. We observed a significant difference in the percentage of comorbidities among age groups, illustrated by the youngest age group (<45 years) having the highest percentage of cases with depression (24.6%), compared with a frequency of 16.1% in those >65 years.

Conclusions Our findings highlight the high frequency of comorbidity in people with OA, with depression having the highest age-standardised prevalence rate. Comorbidities differentially affect females, and vary by age. These factors should inform healthcare programme and delivery.

  • osteoarthritis
  • comorbidity
  • depression
  • hypertension
  • COPD
  • administrative health data

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-033334

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    Footnotes

    • Contributors DAM, PDF and KY were responsible for the conception and design of the research, acquisition of the data, analysis and interpretation of data, drafting the article and revision of the article for important intellectual content. XL was responsible for the analysis and interpretation of data, drafting the article and revision of the article for important intellectual content. ChB, ClB, DM, TN, JW and LL were responsible for the conception and design of the research, interpreting results of the research and revision of the article for important intellectual content. All authors approved the final version of the manuscript to be submitted. DAM (damarsha@ucalgary.ca) and XL (xiaoxili@ucalgary.ca) take responsibility for the integrity of the work as a whole.

    • Funding This research was funded through a Canadian Institute for Health Research (CIHR) Operating Grant (Grant #: 126128) and the Arthur J.E. Child Chair in Rheumatology Research. There were no study sponsors and the funding agencies had no involvement in the study design, collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. DAM was supported by a Canada Research Chair and the Arthur J.E. Child Chair in Rheumatology Research. XL was supported by the Arthur J.E. Child Chair in Rheumatology Research, the Cumming School of Medicine Postdoctoral Scholarship and the Postdoctoral Scholarship funded by the O’Brien Institute of Public Health and the McCaig Institute for Bone and Joint Health.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Ethics approval for this project was provided by the Conjoint Health Research Ethics Board at the University of Calgary (REB13-0100).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.