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Open Access Study protocol

Functional outcome in older adults with joint pain and comorbidity: design of a prospective cohort study

Lotte AH Hermsen1*, Stephanie S Leone1, Daniëlle AWM van der Windt2, Martin Smalbrugge3, Joost Dekker4 and Henriëtte E van der Horst1

Author Affiliations

1 Department of General Practice and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

2 Arthritis Research UK, Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK

3 Department of Nursing Home Medicine and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

4 Department of Rehabilitation Medicine and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

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BMC Musculoskeletal Disorders 2011, 12:241  doi:10.1186/1471-2474-12-241

Published: 24 October 2011

Abstract

Background

Joint pain is a highly prevalent condition in the older population. Only a minority of the older adults consult the general practitioner for joint pain, and during consultation joint pain is often poorly recognized and treated, especially when other co-existing chronic conditions are involved. Therefore, older adults with joint pain and comorbidity may have a higher risk of poor functional outcome and decreased quality of life (QoL), and possibly need more attention in primary care. The main purpose of the study is to explore functioning in older adults with joint pain and comorbidity, in terms of mobility, functional independence and participation and to identify possible predictors of poor functional outcome. The study will also identify predictors of decreased QoL. The results will be used to develop prediction models for the early identification of subgroups at high risk of poor functional outcome and decreased QoL. This may contribute to better targeting of treatment and to more effective health care in this population.

Methods/Design

The study has been designed as a prospective cohort study, with measurements at baseline and after 6, 12 and 18 months. For the recruitment of 450 patients, 25 general practices will be approached. Patients are eligible for participation if they are 65 years or older, have at least two chronic conditions and report joint pain on most days. Data will be collected using various methods (i.e. questionnaires, physical tests, patient interviews and focus groups). We will measure different aspects of functioning (e.g. mobility, functional independence and participation) and QoL. Other measurements concern possible predictors of functioning and QoL (e.g. pain, co-existing chronic conditions, markers for frailty, physical performance, psychological factors, environmental factors and individual factors). Furthermore, health care utilization, health care needs and the meaning and impact of joint pain will be investigated from an older person's perspective.

Discussion

In this paper, we describe the protocol of a prospective cohort study in Dutch older adults with joint pain and comorbidity and discuss the potential strengths and limitations of the study.