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THU0421 Musculoskeletal Diseases Have the Worst Impact on Physical Health Compared with Other Diseases – Results of A Dutch Epidemiological Study
  1. A. Van Der Zee-Neuen1,
  2. P. Putrik1,2,
  3. S. Ramiro3,
  4. A. Keszei4,
  5. R. de Bie4,
  6. A. Chorus5,
  7. A. Boonen1
  1. 1Rheumatology, Maastricht University, CAPHRI, MUMC
  2. 2Health Promotion, Maastricht University, Maastricht
  3. 3Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center (ARC), Amsterdam
  4. 4Epidemiology, Maastricht University, Maastricht
  5. 5Life Style/BSS, TNO, Leiden, Netherlands


Background Musculoskeletal conditions (MSKC) are among the most common chronic conditions. Increasingly, patients suffer from more than one disease. The presence of a co-morbid disease adds to the burden of single diseases worldwide.

Objectives The aim of this study was to explore 1) the impact of the number of morbidities on health, 2) whether MSKC have a higher impact on health compared with other diseases and 3) whether MSKC have an important impact on health independently of the number of co-morbidities

Methods In a Dutch cross-sectional study, 8904 subjects (>18 years old, random sample) completed a questionnaire on sociodemographic factors, smoking status, BMI, self-reported physician-diagnosed diseases and the 12-Item Short-Form Health Survey (SF-12). Missing values were handled using multiple imputation. Multivariable linear regression was computed to identify 1) whether multimorbidity in terms of number of diseases was significantly associated with the SF-12 physical (PCS) and mental (MCS) subscales, 2) which diseases contributed the most to changes in health and 3) whether MSKC as co-morbidity were associated with additional decrease in PCS/MCS independently of the number of morbidities. Models were adjusted for age, gender, education, origin and BMI. Multilevel analyses were performed to identify possible differences at the level of postal code. Multilevel analyses were performed to identify possible differences by place of residence (postal code).

Results Multimorbidity was present in 1722 subjects (19%). MSKC was reported by 1766 (20%) participants. 547 (6%) reported diabetes,1855 (21%) CVD, 270 (3%) cancer, 679 (8%) a respiratory condition, 630 (7%) a skin condition, 526 (6%) a mental disorder, 394 (4%) migraine and 333 (4%) bowel disease. A linear relation between the number of diseases and health was observed. MSKC had the highest negative impact on PCS compared to other diseases (β=-8.37[-8.84;-7.89] (Table 1). In addition, a clinically relevant increase of the effect of each single disease on PCS when co-occurring with MSKC was found.

Conclusions Multimorbidity is prevalent in the Dutch population (19%). A higher number of morbidities results in worse physical and mental health. MSKC have the worst impact on physical health compared to other diseases when occurring alone or when occurring as co-morbid disease.

Disclosure of Interest : None declared

DOI 10.1136/annrheumdis-2014-eular.1678

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