What factors are associated with health-related quality of life among patients with chronic musculoskeletal pain? A cross-sectional study in primary health care

Kirsti Krohn Garnaes, Siv Mørkved, Øyvind Salvesen, Torgrim Tønne, Lars Furan, Gudmund Grønhaug, Ottar Vasseljen, Hege Hølmo Johannessen, Kirsti Krohn Garnaes, Siv Mørkved, Øyvind Salvesen, Torgrim Tønne, Lars Furan, Gudmund Grønhaug, Ottar Vasseljen, Hege Hølmo Johannessen

Abstract

Background: Chronic musculoskeletal pain (CMP) affects daily life function and is the most prevalent disorder in primary health care. The primary objective was to examine demographic factors and pain characteristics associated with reduced health-related quality of life (HRQoL) among patients in primary care reporting CMP. Our secondary objective was to compare HRQoL in patients with and without CMP.

Method: This cross-sectional study was conducted in Trondheim, Norway. Twenty randomly selected GPs, and their listed patients aged 21-58 were invited to participate. Self-reported CMP data was collected using online questionnaires. HRQoL was measured by the 15D questionnaire, total score of 0.9 was used as cut-off for clinical reduced HRQoL.

Results: A total of 969 patients (650 females) were recruited from six GPs' patient lists, mean age 45.6 (SD 10.1). CMP was reported by 517 (53%). Factors significantly associated with reduced HRQoL were gender (OR 2.0, 95% CI 1.2, 3.4), disability pension (OR 26.6, 95% CI 3.1, 228.0), mood (OR 1.3, 95% CI 1.1, 1.6), relations with other people (OR 0.8, 95% CI 0.6, 0.9), sleep (OR 1.2, 95% CI 1.0, 1.3) and enjoyment (OR 1.2, 95% CI 1.0). CMP patients had significantly lower total HRQoL score compared to patients without CMP (Between group difference 0.08, 95% CI 0.07-0.09). Half of the CMP patients reported a HRQoL score < 0.9 compared to 14% in the no CMP group.

Conclusions: Being female, receiving disability pension, and several psychosocial factors were found highly associated with reduced HRQoL in CMP patients, whereas pain characteristics were not. Patients with CMP reported statistically and clinically significant lower HRQoL than patients without CMP. Due to low response rate the conclusions must be handled with caution.

Trial registration: Clinicaltrials.gov (NCT02020772).

Keywords: Chronic musculoskeletal pain; Health‐related quality of life; Multisite pain; Psychosocial factors; Risk factors.

Conflict of interest statement

The authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow-chart of study participants (n = 969)
Fig. 2
Fig. 2
HRQoL measured by 15D HRQoL questionnaire among patients with and without CMP, presented by mean sub-score for all 15 dimensions and the mean total 15D HRQoL score

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