骨关节炎患者共病特征和治疗现状:一项基于社区诊疗数据的横断面调查OA

Background Osteoarthritis(OA)is a chronic,disabling disease and one of the most common comorbidities in older adults.Community health centres are the optimal setting for delivering long-term,personalized health management to OA patients and those with multiple comorbidities.Conducting surveys within these centres can determine the current state of health management and treatment for individuals with OA.Currently,research on the comorbidity characteristics and diagnostic and therapeutic status of OA patients remains inadequate.Objective To describe the comorbidity patterns and current treatment status of patients with OA in community health centres in Beijing,for informing future strategies for managing OA in the context of multimorbidity.Methods A purposive sampling method was used in this cross-sectional study used to select four community health centres in Beijing,each provided over 50 000 consultations per year.Electronic medical records of patients diagnosed with OA between June 2020 and June 2024 were retrieved.Patient data were merged using unique patient identifiers.Key variables included gender,age,occupation,diagnoses,number of visits,and treatments.Patients were grouped by comorbidity status,and the differences in clinical characteristics and treatment status between patients with single disease and comorbidities were analyzed.Results A total of 10 552 OA patients were included,representing 31.1%of all outpatients.The average age was(65.1±14.2)years,4 293 patients(40.7%)were males and 6 259 patients(59.3%)were females.On average,patients had(10.5±13.1)visits during the study period and(3.9±2.1)diagnoses.In total,860 patients(8.2%)had OA only,while 4 320(40.9%)had 1-2 other chronic conditions.The most frequent comorbidities were cardiovascular diseases(52.4%),endocrine and metabolic conditions(35.6%),respiratory diseases(35.2%),musculoskeletal conditions(34.1%),and digestive system disorders(27.3%).Hypertension(24.4%),coronary heart disease(20.8%),dyslipidemia(15.2%),osteoporosis(11.9%),and type 2 diabetes(11.7%)were the most prevalent diagnoses.A total of 5 013 patients(47.5%)received OA-related treatment,with an average of(3.92±2.31)treatment types.Treatment patterns included oral medications(73.2%),topical agents(24.6%),and external traditional Chinese therapies(2.3%).The most frequently used oral medications were Chinese herbal medicines or prepared Chinese medicines(43.2%),followed by anti-inflammatory drugs(18.7%),anti-osteoporotic agents(6.3%),and anxiolytics(5.0%).Older patients had a higher prevalence of comorbidities(93.0%),comparing with younger patient(88.7%),and the proportion with more than 10 comorbidities rose from 1.0%of younger patients to 2.1%of older patient.Patients had other chronic conditions had significantly more visits(P<0.01)and received more treatment approaches(P<0.001).Regression analysis identified age,comorbidity status,and number of visits as independent predictors of treatment diversity(P<0.01).Conclusion Over 90%of OA patients in Beijing community health centres present with at least one chronic comorbidity,most commonly cardiovascular diseases(hypertension,coronary heart disease)and metabolic diseases(dyslipidemia,osteoporosis and type 2 diabetes).Compared to patients with OA only,those had other chronic conditions require more frequent visits and more complex treatment.Community-based OA management predominantly involves oral medications,particularly Chinese traditional and anti-inflammatory drugs.