[Chronic musculoskeletal conditions and comorbidities in primary care settings]
Catherine Hudon1, Martin Fortin, Hassan Soubhi
1Département de médecine de famille de l'Université de Sherbrooke au Québéc. catherine.hudon@usherbrooke.ca
Objective:
To estimate the prevalence of chronic musculoskeletal conditions in primary care. Among patients with these conditions, to estimate the mean number of comorbidities and the prevalence of chronic diseases that could deteriorate with use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Design:
Secondary analysis of data collected for a study on the prevalence of multimorbidity.
Setting:
Twenty-one family medicine practices in the region of Saguenay, Que.
Participants:
Two-tier sample consisting of family physicians (first tier) and their patients (second tier) recruited during consecutive consultation periods.
Main Outcome Measures:
Percentage of patients with chronic musculoskeletal conditions. Within this sub-sample, average number of comorbidities and percentage of patients with chronic diseases, such as hypertension, cardiovascular disease, renal disease, and stomach ulcers or reflux, that could deteriorate with use of NSAIDs.
Results:
Among the 980 patients in the database, 58% had chronic musculoskeletal conditions. Average age of patients was 56 years. Among patients with these conditions,the number of comorbidities ranged from 0 to 11; the average number was 4. About 49% of patients had hypertension; 31% had cardiovascular disease; 31% had urinary problems or renal disease; and 17% had stomach ulcers or reflux. About 70% of patients with chronic musculoskeletal conditions had at least 1 of the 4 comorbidities mentioned.
Conclusion:
More than half the patients who consult in primary care have chronic musculoskeletal conditions. The average number of comorbidities these patients have is high; many present with comorbidities that can deteriorate with use of NSAIDs. Family physicians must, therefore, exercise caution when using NSAIDs for patients with musculoskeletal conditions.
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