Exploring multimorbidity in patients with spinal pain - A study on the potential impact of comorbidity on patient clinical trajectories

Persistent neck or back pain (spinal pain) is a prevalent condition affecting many individuals worldwide, leading to significant health and socioeconomic consequences. A substantial portion of this individual and societal burden can be attributed to the coexistence of spinal pain with other health conditions. Despite the high prevalence of multimorbidity among individuals with spinal pain, clinical trials and guidelines often fail to account for the complex interactions between spinal pain and other chronic conditions. This oversight results in fragmented care that does not adequately address patients' overall health needs.
Currently, there is a lack of precise knowledge regarding the prevalence of multimorbidity within this patient group, the consequences it entails, and the potential barriers and facilitators experienced by individuals with multimorbidity and a high treatment burden in participating and benefitting from rehabilitation services.

To investigate aspects, the following studies will be conducted:

Study 1: A cross-sectional study aimed at determining the prevalence of multimorbidity among patients with spinal pain referred to outpatient clinics, (Department of Rheumatology at Aalborg University Hospital and the Medical Spine Clinic in Silkeborg). Regression analysis will assess the associations between the number and clusters of chronic conditions and both primary and secondary outcomes, as well as healthcare service utilization. Data collection will utilize the hospital's electronic journal systems, patient-reported outcome measures (PROMs), and external Danish registers, ensuring a comprehensive understanding of the patient population.

Study 2: An observational prospective cohort study conducted over 12 months to assess the associations between treatment burden arising from multimorbidity and patient prognosis in structured rehabilitation settings. Similar to Study 1, data will be sourced from the hospital's electronic journal systems and external Danish registers. PROMs will be collected at 3, 6, and 12 months, allowing for ongoing assessment and providing a stronger understanding of patient trajectories and treatment dynamics over time.

Study 3: A qualitative study employing semi-structured interviews with individuals who have previously undergone treatment at the Department of Rheumatology at Aalborg University Hospital. Participants will be purposefully selected based on the presence of two or more chronic diseases and a high self-reported treatment burden. This study will explore their lived experiences and the challenges they encounter in participating in and benefiting from structured rehabilitation.

Overall, this project aims to provide a comprehensive understanding of the extent and impact of multimorbidity among individuals with chronic spinal pain. It will generate insights to improve healthcare services, better accommodating the complexities of patients' conditions and ultimately laying the groundwork for more cohesive and integrated treatment approaches.