Comorbidity and healthcare utilization in osteoarthritis; a primary care survey from Odisha, India

Background: The study aimed to explore the pattern of comorbidities among Osteoarthritis (OA) patients attending urban primary care settings and its association with healthcare utilization. Methods: Age ( +/- 3 years) and sex matched (1:1) case-control study was done among randomly selected 514 people (OA + non-OA) attending primary care settings. Information was collected on 18 comorbidities and healthcare utilization was measured by number of hospital visits in last one year and numbers of medicines taken daily. Multivariate logistic regression was used to examine the association with multimorbidity and linear regression analysis was performed for identifying association between healthcare utilization and comorbidities. Result: There were 260 radiologically confirmed OA cases and 254 matched controls. The mean age of people with OA was 52.7 years compared to 54.5 years in controls. Mean number of comorbidities among OA was 2.5. Leading comorbidities were acid peptic diseases, chronic back pain, hypertension and diabetes. The adjusted odds of having two or more comorbidities among OA patients was 1.8 [95% CI 1.4-2.2]. The adjusted beta coefficient for number of medicines taken was 0.5 [95% CI 0.2-0.8] in OA patients with two or more comorbidities compared to non-OA with less than two comorbidities. The hospital visits were 0.7 times less among OA patients with two or more comorbidities compared to non-OA with less than two comorbidities after adjusting for other variables. Conclusion: Osteoarthritis has significant association with multimorbidity, which increases medicines intake and health care utilization. Comorbidities in OA should be considered for designing integrated care approach.