Associations of multiple (≥5) chronic conditions among a nationally representative sample of older United States adults with self-reported pain

Author:

Axon David R.1ORCID,Arku Daniel1

Affiliation:

1. University of Arizona College of Pharmacy , Tucson , AZ , USA

Abstract

Abstract Objectives The association between an individuals’ demographic and health characteristics and the presence of multiple chronic conditions is not well known among older United States (US) adults. This study aimed to identify the prevalence and associations of having multiple chronic conditions among older US adults with self-reported pain. Methods This retrospective, cross-sectional study used data from the 2017 Medical Expenditure Panel Survey. Study subjects were aged ≥50 years and had self-reported pain in the past four weeks. The outcome variable was multiple (≥5) chronic conditions (vs. <5 chronic conditions). Hierarchical logistic regression models were used to identify significant associations between demographic and health characteristics and multiple chronic conditions with significance indicated at an a priori alpha level of 0.05. The complex survey design was accounted for when obtaining nationally-representative estimates. Results The weighted population was 57,074,842 US older adults with pain, of which, 66.1% had ≥5 chronic conditions. In fully-adjusted analyses, significant associations of ≥5 comorbid chronic conditions included: age 50–64 vs. ≥65 years (adjusted odds ratio [AOR]=0.478, 95% confidence interval [CI]=0.391, 0.584); male vs. female gender (AOR=1.271, 95% CI=1.063, 1.519); white vs. other race (AOR=1.220, 95% CI=1.016, 1.465); Hispanic vs. non-Hispanic ethnicity (AOR=0.614, 95% CI=0.475, 0.793); employed vs. unemployed (AOR=0.591, 95% CI=0.476, 0.733); functional limitations vs. no functional limitations (AOR=1.862, 95% CI=1.510, 2.298); work limitations vs. no work limitations (AOR=1.588, 95% CI=1.275, 1.976); little/moderate vs. quite a bit/extreme pain (AOR=0.732, 95% CI=0.599, 0.893); and excellent/very good (AOR=0.375, 95% CI=0.294, 0.480) or good (AOR=0.661, 95% CI=0.540, 0.810) vs. fair/poor physical health. Conclusions Approximately 38 million of the 57 million US older adults with pain in this study had ≥5 chronic conditions in 2017. Several characteristics were associated with multiple chronic conditions, which may be important for health care professionals to consider when working with patients to manage their pain. This study was approved by The University of Arizona Institutional Review Board (2006721124, June 12, 2020).

Publisher

Walter de Gruyter GmbH

Subject

Anesthesiology and Pain Medicine,Neurology (clinical)

Reference47 articles.

1. Roberts, AW, Ogunwole, SU. The population 65 years and older in the United States: 2016. American Community Survey Reports; 2018. Available from: https://www.census.gov/content/dam/Census/library/publications/2018/acs/ACS-38.pdf [Accessed 25 May 2021].

2. Schneider, KM, O’Donnell, BE, Dean, D. Prevalence of multiple chronic conditions in the United States’ Medicare population. Health Qual Life Outcome 2009;7:82. https://doi.org/10.1186/1477-7525-7-82.

3. Federal Interagency Forum on Aging-Related Statistics. Older Americans 2016 – key indicators of well-being federal interagency forum on aging-related statistics 2016. Available from: https://agingstats.gov/docs/LatestReport/Older-Americans-2016-Key-Indicators-of-WellBeing.pdf [Accessed 25 May 2021].

4. Vogeli, C, Shields, AE, Lee, TA, Gibson, TB, Marder, WD, Weiss, KB, et al.. Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med 2007;22:391–5. https://doi.org/10.1007/s11606-007-0322-1.

5. Ward, BW, Schiller, JS. Prevalence of multiple chronic conditions among US adults: estimates from the National Health Interview Survey, 2010. Prev Chronic Dis 2013;10:120203.

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