OP0140-PARE The complexity of living with rheumatic and musculoskeletal diseases and other health problems
Authors: J. Cumming, R.G. Hull
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Many people in the UK report they are living with additional health problems to their diagnosed rheumatic or musculoskeletal diseases (RMDs). It is well recognised that ischaemic heart disease and stroke are commoner in acute active rheumatoid arthritis It has been observed that the support and information needs of these people may be higher than those without co-morbidities. We felt further analysis of these individuals on a national database could examine the issues further. <h3>Objectives</h3> We analysed all contacts reporting additional health problems to their RMD to a national helpline during 2011 <h3>Methods</h3> Every contact by telephone, email, letter or online forum received in the helpline was anonymised and logged onto a secure confidential database complying with the UK Data Protection Act. Where co morbidities were self reported this was collated and analysed. <h3>Results</h3> The helpline received a total of 11,526 contacts in 2011, of which 784 (8%) reported they had at least one additional health problem. Of these nearly a quarter said they had more than one additional health problem. When the whole group was analysed (784), the commonest reported health problem was Osteoporosis [23%]. Next 17.8% reported mental health problems, most commonly depression. Heart conditions were third at 2.5% and 10% reported high blood pressure. The majority of contacts reporting co-morbidities were adults over 25 years Where osteoporosis was reported [n=186] 42% of these contacts were usually aged over 26 to 64 and 58% over 65. 140 adults reported mental health problems – commonly depression but only 32% over 65 years reported this. Individual RMDs have different co-morbidities reported: Osteoarthritis (n=555) patients reported Osteoporosis [21%], followed by depression [14.9%], heart disease [10%], diabetes [8%] and hypertension [8%]. Many of these may be related to higher age in contacts with osteoarthritis. People reporting co-morbidities and rheumatoid arthritis (n=70) are more likely to also report depression [20%] followed by heart problems [15%]. 23% of those with co-morbidities and fibromyalgia (n=43) also report they are being treated for mental health problems and 18% with osteoporosis. In support terms clients with co-morbidities report having higher levels of symptoms or emotional and information needs. All (100%) report they experience chronic pain compared to 61% of contacts who do not have co-morbidities. 28.8% said this made them feel low and depressed and have problems with fatigue. People with co-morbidities need more help understanding their treatments 36% compared with 16% who have none. 16% of clients with co-morbidities were referred on to other support agencies. <h3>Conclusions</h3> We have demonstrated that 8% of contacts in one year had co-morbidities which affected their daily life. These varied with age and primary RMD High levels of pain reported may result in significant increases in feelings of depression and fatigue and the need for one to one counselling support. Where additional health problems are reported by people with rheumatic and musculoskeletal diseases there are generally higher support and information needs. <h3>Disclosure of Interest</h3> None Declared