PhD defence A. (Anne) Kamps

Below is a brief summary of the dissertation:

Osteoarthritis (OA) is a chronic condition with a significant impact on individuals and society. Its global prevalence is rising, and there is no disease-modifying drug available. OA often coexists with multiple chronic conditions, complicating its management through polypharmacy, overlapping symptoms, and barriers to therapy.
This thesis explored the relationship between OA and around sixty chronic conditions across four European countries. Using large primary care databases and genetic data, it examined patterns of comorbidities diagnosed before and after OA, obesity’s role as a risk factor, and the impact on patient experiences. Findings revealed that 72% of comorbidities were more common prior to OA diagnosis, particularly musculoskeletal conditions and obesity. Cardiometabolic conditions like hypertension and type 2 diabetes were also prevalent. Several unexpected associations, including liver cirrhosis, chronic fatigue syndrome, and migraine, were found. Moreover, the incidence of many conditions increased after OA diagnosis, including obesity, fibromyalgia, and mental health disorders like depression.
Comorbidities tend to appear in distinct clusters, such as groups with musculoskeletal pain and mental health issues, cardiovascular conditions, or multimorbidity. The thesis also highlighted a clear causal relationship between obesity and knee, hip, and hand OA. Qualitative research revealed patients’ challenges with fragmented healthcare systems, medication interactions, and a lack of guidance. The findings emphasize the importance of addressing multimorbidity in OA care to improve outcomes for patients.