Association Between Multimorbid Disease Patterns and Pain Outcomes Among a Complex Chronic Care Population in Canada
Received 27 June 2020
Accepted for publication 8 October 2020
Published 20 November 2020 Volume 2020:13 Pages 3045—3057
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Robert B. Raffa
Meaghan Ferguson,1 Anton Svendrovski,2 Joel Katz1
1Department of Psychology, Faculty of Health, York University, Toronto, Ontario, Canada; 2Department of Psychology, UZIK Consulting Inc, Toronto, Ontario, Canada
Correspondence: Meaghan Ferguson; Joel Katz
York University, 232 Behavioural Science Building, 4700 Keele Street, Toronto M3J 1P3, Ontario, Canada
Tel +1 647 218 6717
; +1 416 736 2100 ext. 40557
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Purpose: Disease multimorbidity and pain is a complex, yet common, problem for the aging population, and a significant burden on the health-care systems around the world. Despite this, disease comorbidity and the association with pain in a complex chronic care population is not well understood. This study examined the most prevalent disease combinations and their association with pain.
Patients and Methods: The study initially included 139,920 residents, aged 18– 101 years, admitted to publicly funded hospital facilities for complex chronic care in Canada between the years 2006 and 2016. Data were acquired through the Canadian Institute for Health Information (CIHI) Facility-Based Continuing Care Reporting System (CCRS). Descriptive and chi-square statistics were used to summarize and compare the sample characteristics. Binary logistic regression analyses were used to examine the association between multimorbid disease categories and pain outcomes.
Results: The sample consisted of 139,573 residents (57% female), mostly older (mean age = 77.32 years), married (40%), or widowed (36%). Residents took an average of 11.9 medications and 77% were using analgesic medications. On average, residents had diagnoses from 3.06 disease categories (SD = 1.43). Heart/circulation diseases were the most prevalent among the sample (73%), with neurological second (46%) and musculoskeletal third (44%). Overall, 73% of residents reported pain, with 43% reporting moderate pain severity. Residents with multiple disease categories were more likely to report the presence of pain (OR = 1.08, 95% CI: 1.07– 1.08, p < 0.001), with each additional disease category associated with an 8% increase in the odds of reporting pain.
Conclusion: The findings from this study help identify common comorbid disease patterns related to pain in an institutionalized, complex chronic care population. This information contributes to both the pain and multimorbidity literature, and is invaluable for creating care plans to meet the demands of a challenging population.
Keywords: complex chronic disease, comorbidity, disease categories, health, health psychology
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