Association between multimorbidity and chronic pain among adults: a national analysis of NHIS data

Abstract

Objective: This study aimed to explore the relationship between multimorbidity and chronic pain and therefore help in establishing collective management guidelines for patients with multiple chronic conditions. Methods: A cross-sectional analysis of the National Health Interview Survey (NHIS) data was conducted from 2019-2021; 93,047 individuals were included. The dependent variable was self-reported chronic pain. Multimorbidity was defined as the presence of two or more chronic conditions, including hypertension, diabetes mellitus, hypercholesterolemia, obesity, chronic obstructive pulmonary disease, and arthritis. Multivariate regression analysis was utilized to evaluate the independent association between multimorbidity and chronic pain. Predicted probability analyses were used to assess the relationship between multimorbidity, pain severity, and pain-related functional limitation. Results: Chronic pain was reported by 57,424 (61.7%) of the participants. Multimorbidity was significantly more prevalent among those with chronic pain compared with those without (45.0% vs. 19.9%, p<0.001). After adjustment for confounders, multimorbidity remained independently associated with chronic pain (aOR ≤ 2.42, p<0.001). Also, individuals with multimorbidity had higher predicted probabilities of greater pain intensity and pain-related functional limitation. Conclusion: Multimorbidity was independently associated with chronic pain and was associated with greater pain severity and functional limitation. These findings highlighted the need for integrated management of patients with multimorbidity.