title: Associations between multimorbidity and additional burden for working-age adults with specific forms of musculoskeletal conditions: a cross-sectional study.
abstract: Multiple health conditions are increasingly a problem for adults with musculoskeletal conditions. However, multimorbidity research has focused primarily on the elderly and those with a limited subset of musculoskeletal disorders. We sought to determine whether associations between multimorbidity and additional burden differ with specific forms of musculoskeletal conditions among working-age adults.
  
  
  
  Data were sourced from a nationally representative Australian survey. Specific musculoskeletal conditions examined were osteoarthritis; inflammatory arthritis; other forms of arthritis or arthropathies; musculoskeletal conditions not elsewhere specified; gout; back pain; soft tissue disorders; or osteoporosis. Multimorbidity was defined as the additional presence of one or more of the Australian National Health Priority Area conditions. Burden was assessed by self-reported measures of: (i) self-rated health (ii) musculoskeletal-related healthcare and medicines utilisation and, (iii) general healthcare utilisation. Associations between multimorbidity and additional health or healthcare utilisation burden among working-age adults (aged 18 - 64 years of age) with specific musculoskeletal conditions were estimated using logistic regression, adjusting for confounders. Interaction terms were fitted to identify whether there were specific musculoskeletal conditions where multimorbidity was more strongly associated with poorer health or greater healthcare utilisation than in the remaining musculoskeletal group.
  
  
  
  Among working-age adults, for each of the specified musculoskeletal conditions, multimorbidity was associated with similar, increased likelihood of additional self-rated health burden and certain types of healthcare utilisation. While there were differences in the relationships between multimorbidity and burden for each of the specific musculoskeletal conditions, no one specific musculoskeletal condition appeared to be consistently associated with greater additional health burden in the presence of multimorbidity across the majority of self-rated health burden and healthcare use measures.
  
  
  
  For working-age people with any musculoskeletal conditions examined here, multimorbidity increases self-reported health and healthcare utilisation burden. As no one musculoskeletal condition appears consistently worse off in the presence of multimorbidity, there is a need to better understand and identify strategies that acknowledge and address the additional burden of concomitant conditions for working-age adults with a range of musculoskeletal conditions.
authors.affiliation: Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia. d.lowe@latrobe.edu.au.|Cochrane Consumers and Communication Review Group, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia. d.lowe@latrobe.edu.au.
authors.forename: Dianne B
authors.initials: DB
authors.lastname: Lowe
authors.affiliation: School of Allied Health, Australian Catholic University, Fitzroy, Australia.|Cochrane Consumers and Communication Review Group, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Taylor
authors.affiliation: Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.|Cochrane Consumers and Communication Review Group, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.
authors.forename: Sophie J
authors.initials: SJ
authors.lastname: Hill
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D055815:Young Adult
keywords: Healthcare utilisation; Multimorbidity; Musculoskeletal conditions; Quality of life