Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Multiple Medications Use in Adults with Chronic Disease, with and without a Musculoskeletal Condition.

Hawker3,  Gillian A., Croxford1,  Ruth, Badley2,  Elizabeth M.

Institute of Clinical and Evaluative Sciences, Toronot, Canada
Toronto Western Research Institute, Toronto, ON, Canada
Women's College Hospital, Toronto, ON, Canada


Musculoskeletal (MSK) conditions, which disproportionately affect older adults, are the most common cause of pain and long term disability. Chronic medication use is central to symptomatic management of MSK conditions and their downstream effects (e.g. sleep disruption and depressed mood). However, their chronic use may increase risk for adverse outcomes. This study evaluated the prevalence and correlates of use of combinations of medications (pain relievers, narcotic medications, and anti-depressants) among people with MSK and non-MSK chronic conditions.


Data from Ontario respondents to the 2001 Canadian Community Health Survey (CCHS) (Cycle 1.1), a nationally representative cross-sectional survey of the Canadian community-dwelling population, were used. Participants aged 25 years and older who responded to the questions about MSK conditions (physician diagnosed arthritis or rheumatism and back pain) and about their medication use in the past month, including the use of pain relievers (e.g., aspirin, acetaminophen, arthritis medicine or anti-inflammatories), narcotic medications (codeine, Demerol or morphine), and anti-depressants (e.g., Prozac, Paxil or Effexor), were included. The age-standardized percentage of Ontario respondents aged 25+ years who reported taking two or more of these types of medications (i.e. multiple medication use) was calculated for those with a MSK condition compared to those with one or more non-MSK chronic conditions (e.g. pulmonary disease, diabetes, heart disease). Among respondents with at least 1 chronic condition, correlates of multiple medication use (yes/no) were evaluated using logistic regression. Correlates considered were: age, gender, MSK condition, number of other chronic conditions, and annual household income.


Among ~ 26,000 respondents, 34.9% reported an MSK condition and 12.1% reported at least one non-MSK chronic condition. The percentage reporting multiple medication use was 16.2% in those with an MSK condition and 9.5% in those with at least one non-MSK chronic condition. Significant independent correlates of multiple medication use were: a greater number of chronic conditions (adj OR for 2 versus 1 condition 1.35; p=0.003; adjusted OR for 3+ versus 1 condition is 3.24; p<0.0001); lower income (p=0.004); and an age-sex interaction (p=0.02). Younger women were more likely to be using multiple medications than younger men, but the probabilities were similar among older men and women. Controlling for these factors, the presence of a MSK condition was independently associated with a higher likelihood of multiple medication use (adjusted OR 1.68, p<0.0001).


People with MSK conditions are almost twice as likely as adults with other chronic conditions to be using combinations of medications typically used to manage chronic pain, potentially increasing their risk for adverse drug effects leading to hospitalization and death.

To cite this abstract, please use the following information:
Hawker, Gillian A., Croxford, Ruth, Badley, Elizabeth M.; Multiple Medications Use in Adults with Chronic Disease, with and without a Musculoskeletal Condition. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2208
DOI: 10.1002/art.29972

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