title: Frequency of comorbid insomnia, pain, and depression in older adults with osteoarthritis: predictors of enrollment in a randomized treatment trial.
abstract: OBJECTIVE
  This paper examines the prevalence and severity of comorbid pain, insomnia, and depression in a population sample of older adults with osteoarthritis (OA), and assesses characteristics distinguishing participants from non-participants in a randomized clinical trial to improve pain and sleep.
  
  
  METHODS
  Potential subjects were Group Health Cooperative members, aged 60+, who had an electronic medical record OA diagnosis in the prior 3 years. Participants were recruited using a low-cost mailed survey. Fifty-five percent of surveys were completed and returned (n=3321). Persons with Grade II-IV arthritis pain on the Graded Chronic Pain Scale and reporting sleep difficulties 3+ nights/week during the past month with daytime dysfunction (n=834) were invited to participate in one of three group-format behavioral self-management interventions. A total of 367 participants attended the first group class.
  
  
  RESULTS
  One-third (36.4%) of survey respondents had clinically elevated levels of OA pain and insomnia. Group participants and non-participants did not differ in ratings of pain severity, sleep disturbance, depression, or receipt of prescription medications for pain or sleep. Participants were significantly older (p<.001) and more likely to be retired (p<.001) than subjects who were eligible to participate but did not.
  
  
  CONCLUSIONS
  Participation in a group-format behavioral intervention for pain and insomnia was not related to participant clinical characteristics, but only to factors associated with ability to attend a daytime class (age and retirement status). We conclude that population-based recruitment yielded randomized trial participants who are clinically generalizable to the population of OA patients with significant pain and insomnia.
authors: Department of Psychosocial and Community Health, University of Washington, Seattle, WA, USA. smccurry@u.washington.edu
authors: Susan M
authors: SM
authors: McCurry
authors: Michael
authors: M
authors: Von Korff
authors: Michael V
authors: MV
authors: Vitiello
authors: Kathleen
authors: K
authors: Saunders
authors: Benjamin H
authors: BH
authors: Balderson
authors: Amy L
authors: AL
authors: Moore
authors: Bruce D
authors: BD
authors: Rybarczyk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000453:epidemiology*; D010146:Pain / Q000453:epidemiology*; D010147:Pain Measurement; D018579:Patient Selection; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*