Relative Impact of Multimorbid Chronic Conditions on Health-Related Quality of Life – Results from the MultiCare Cohort Study

Abstract

BackgroundMultimorbidity has a negative impact on health-related quality of life (HRQL). Previous studies included only a limited number of conditions. In this study, we analyse the impact of a large number of conditions on HRQL in multimorbid patients without preselecting particular diseases. We also explore the effects of these conditions on the specific dimensions of HRQL.Materials and MethodsThis analysis is based on a multicenter, prospective cohort study of 3189 multimorbid primary care patients aged 65 to 85. The impact of 45 conditions on HRQL was analysed. The severity of the conditions was rated. The EQ-5D, consisting of 5 dimensions and a visual-analogue-scale (EQ VAS), was employed. Data were analysed using multiple ordinary least squares and multiple logistic regressions. Multimorbidity measured by a weighted count score was significantly associated with lower overall HRQL (EQ VAS), b = −1.02 (SE: 0.06). Parkinson’s disease had the most pronounced negative effect on overall HRQL (EQ VAS), b = −12.29 (SE: 2.18), followed by rheumatism, depression, and obesity. With regard to the individual EQ-5D dimensions, depression (OR = 1.39 to 3.3) and obesity (OR = 1.44 to 1.95) affected all five dimensions of the EQ-5D negatively except for the dimension anxiety/depression. Obesity had a positive effect on this dimension, OR = 0.78 (SE: 0.07). The dimensions “self-care”, OR = 4.52 (SE: 1.37) and “usual activities”, OR = 3.59 (SE: 1.0), were most strongly affected by Parkinson’s disease. As a limitation our sample may only represent patients with at most moderate disease severity.ConclusionsThe overall HRQL of multimorbid patients decreases with an increasing count and severity of conditions. Parkinson’s disease, depression and obesity have the strongest impact on HRQL. Further studies should address the impact of disease combinations which require very large sample sizes as well as advanced statistical methods.

Multimorbidity and Health-Related Quality of Life among Older Adults

“…This result is consistent across studies that consider only a limited number of chronic conditions, some as low as 11 conditions [11], and those that incorporate a larger number of chronic conditions, one incorporating as high as 45 conditions [12]. The latter study which also derives weighted counts showed that severity should be an important consideration in HRQoL studies among those with multimorbidity.…”

Chronic health conditions related to quality of life for federal civil servants

“…These fi ndings corroborate the results of our study, since affl icted the civil servants affl icted with a chronic health condition had better overall total scores, followed by those with two, and three chronic health conditions, who had a lower mean total score (12)(13) .…”

Life Quality: The Night Shift Work Challenge To Nursing Team / Qualidade de Vida: O Desafio do Trabalho Noturno Para a Equipe de Enfermagem

“…15 This is because it acts in the main domains of life and contributes to health and well-being with physical, psychological and social benefits. [15][16][17] Research carried out in health units in Coimbra-Portugal⁶ and Minas Gerais 10 pointed out that married or those who have partners have better LQ, as well as the results of this study, in which workers with a partner have higher scores when compared to those without partners in the field of social relationship. Because having a partner suggests greater comfort and emotional support, since responsibility for home, children, spouse, among others, contributes to better deal with problems that may occur.…”