The Role of Patients' Social Networks in Shaping the Experience of Musculoskeletal Conditions in Multimorbidity

Background: The number of people living with more than one chronic illness (multimorbidity) is increasing. People living with multimorbidity are likely to be active participants in the management and decision making processes around their own conditions. However, emerging evidence suggests that individual patient priorities and decision making processes in relation to multimorbidity are complex.

Patients' social networks—family, friends, and work colleagues—have been identified as an important factor in shaping the ways that patients live with and manage chronic illness. Social networks are understood as a source of social resources and are increasingly recognized in emerging models of healthcare. This study addresses the patient experience of living with both OA and cardiovascular disease (CVD); in particular, it addresses the role of patients' social networks in relation to various aspects of illness self-management.

Methods: The study sample was drawn from an on-going cohort study into OA/CVD comorbidity. Study participants have a diagnosis of both OA and CVD (all participants have further additional conditions). In-depth qualitative interviews were conducted at multiple time points. Interviews focused upon issues relating to living with and managing concurrent conditions, and the role that participants' social networks played in shaping these experiences.

Results: Social networks were found to be a key factor in patients' experiences of multimorbidity. Social networks were an important source of social support—including health information, practical, and emotional support—and played a key role in how patients understand their illnesses. Patients' social networks also influenced the ways in which patients prioritized and managed concurrent conditions, for example, in relation to how they managed polypharmacy and navigated services. However, there were also examples where social networks had a negative affect on how multimorbidity was experienced, for example, some participants spoke of disagreements with their significant others in relation to how their illnesses should be managed.

Conclusions: The patient experience of living with and managing multimorbidity is often highly complex. Patients with multimorbidity routinely draw upon their social network as a source of support and advice. It may be useful to consider issues around the management of multimorbidity in the context of patients' inter-personal social relationships.