{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T02:58:30Z","timestamp":1776913110240,"version":"3.51.2"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006196","name":"University of Oulu","doi-asserted-by":"publisher","award":["24000692"],"award-info":[{"award-number":["24000692"]}],"id":[{"id":"10.13039\/501100006196","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Oulu University Hospital","award":["24301140"],"award-info":[{"award-number":["24301140"]}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["539\/2010 A31592"],"award-info":[{"award-number":["539\/2010 A31592"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Musculoskeletal (MSK) pain is known to influence health-related quality of life (HRQoL), but the role of co-occurring chronic diseases in HRQoL in a MSK pain population has been less studied. This study aimed to evaluate (i) whether chronic disease clusters are related to HRQoL and (ii) whether these relationships differ in magnitude from those between the number of chronic diseases and HRQoL among people with MSK pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Material and methods<\/jats:title>\n                  <jats:p>The Northern Finland Birth Cohort 1966 and its 46-year data collection point were used. The chronic disease clusters for individuals reporting any MSK pain within the past year were previously formulated using latent class analysis and consisted of: Psychiatric (co-existing mental health disorder, substance use disorder, and asthma), Metabolic (referring to the burden of metabolic diseases), and Relatively healthy. HRQoL was measured with a 15-dimension questionnaire. General linear regression model was used.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 4490 participants, both the Psychiatric and Metabolic clusters associated with clinically significantly reduced HRQoL, when contrasted with the Relatively healthy cluster, but the association was stronger for the Psychiatric cluster. Similarly, the adjusted mean difference in HRQoL was higher for the Psychiatric cluster than for the multimorbidity (two or more diseases) category when compared with the reference categories (Relatively healthy cluster and no chronic diseases, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The present findings imply the clinical relevance of the previously identified chronic disease clusters and suggest that pure counts of chronic diseases may not be enough to describe the role of chronic diseases in HRQoL in MSK pain.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmaf057","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T12:01:42Z","timestamp":1752753702000},"source":"Crossref","is-referenced-by-count":3,"title":["Chronic disease clusters and health-related quality of life among individuals with musculoskeletal pain: a Northern Finland Birth Cohort 1966 study"],"prefix":"10.1093","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7156-491X","authenticated-orcid":false,"given":"Eveliina","family":"Heikkala","sequence":"first","affiliation":[{"name":"Research Unit of Health Sciences and Technology, University of Oulu , Oulu ,","place":["Finland"]},{"name":"Medical Research Center Oulu, University of Oulu and Oulu University Hospital , Oulu ,","place":["Finland"]},{"name":"Wellbeing Services County of Lapland , Rovaniemi ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaro","family":"Karppinen","sequence":"additional","affiliation":[{"name":"Research Unit of Health Sciences and Technology, University of Oulu , Oulu ,","place":["Finland"]},{"name":"Medical Research Center Oulu, University of Oulu and Oulu University Hospital , Oulu ,","place":["Finland"]},{"name":"Rehabilitation Services of Wellbeing Services County of South Karelia , Lappeenranta ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"2025071708013934500_CIT0001","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1186\/s12913-022-08180-2","article-title":"Modifiable prognostic factors of high costs related to healthcare utilization among older people seeking primary care due to back pain: an identification and replication study","volume":"22","author":"Killingmo","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"2025071708013934500_CIT0002","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.jclinepi.2021.08.023","article-title":"Recent health-related quality of life, but not change, predicted mortality and healthcare utilization","volume":"140","author":"Singh","year":"2021","journal-title":"J Clin Epidemiol"},{"key":"2025071708013934500_CIT0003","doi-asserted-by":"publisher","first-page":"1596","DOI":"10.1186\/s12889-020-09639-9","article-title":"Quality of life and mortality in the general population: a systematic review and meta-analysis","volume":"20","author":"Phyo","year":"2020","journal-title":"BMC Public Health"},{"key":"2025071708013934500_CIT0004","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/1477-7525-6-98","article-title":"Health predicting factors in a general population over an eight-year period in subjects with and without chronic musculoskeletal pain","volume":"6","author":"Arvidsson","year":"2008","journal-title":"Health Qual Life Outcomes"},{"key":"2025071708013934500_CIT0005","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1186\/s12889-023-16167-9","article-title":"Trajectories of physical function and quality of life in people with osteoarthritis: results from a 10-year population-based cohort","volume":"23","author":"Costa","year":"2023","journal-title":"BMC Public Health"},{"key":"2025071708013934500_CIT0006","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1097\/PHM.0000000000000926","article-title":"Trajectories of quality of life and associated risk factors in patients with knee osteoarthritis: findings from the osteoarthritis initiative","volume":"97","author":"Han","year":"2018","journal-title":"Am J Phys Med Rehabil"},{"key":"2025071708013934500_CIT0007","volume-title":"The 15D-measure of health-related quality of life. 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