Health‐related quality of life of older Asian patients with multimorbidity in primary care in a developed nation

Quah, Joanne Hui Min; Wang, Pei; Ng, Roderica Rui Ge; Luo, Nan; Tan, Ngiap Chuan

doi:10.1111/ggi.12881

Cited by 43 publications

(61 citation statements)

References 20 publications

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“…The study also found that health-related quality of life (HRQoL) among those with multimorbidity was found to be significantly lower as compared to those without chronic conditions [18]. A study among older adults attending primary care clinics in Singapore similarly found that the most commonly reported chronic conditions were hypertension, hyperlipidemia, and diabetes, and multimorbidity was associated with lower HRQoL using the EQ-5D [19].…”

Section: Introductionmentioning

confidence: 94%

Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population

Subramaniam¹,

Zhang²,

Lau³

et al. 2019

Preprint

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Background: The co-occurrence of two or more chronic medical conditions in an individual is defined as multimorbidity. Lifestyle factors, including poor dietary patterns, physical inactivity, tobacco use, and excessive alcohol consumption are key modifiable risk factors that play a role in the development of chronic medical conditions and potentially multimorbidity. The current study aimed to examine the levels of physical activity among those with multimorbidity and its association with socio-demographic factors, clinical parameters, and health-related quality of life (HRQoL) among community-dwelling adults attending a primary care clinic in Singapore. Methods: This cross-sectional study was conducted among patients with multimorbidity between August 2014 and June 2016. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) Short Form. HRQoL was measured using the EuroQol-5 Dimension (EQ-5D-3L). Data on clinical parameters like hemoglobin A1c (HbA1C), low-density lipoprotein cholesterol (LDL-C), and blood pressure were collected from patient records. Multivariable logistic regression analysis and linear regression were performed to determine the association between IPAQ and clinical health outcomes, five subscales of the EQ-5D and EQ-5D index, respectively. Results: In all, 932 respondents with multimorbidity were recruited for the study. Of them, 500 (53.8%) had low physical activity, 325 (35.0%) had moderate physical activity, while 104 (11.2%) had high physical activity. Respondents with moderate and high physical activity had significantly lower odds of being overweight (OR: 0.57, 95% confidence interval [CI]: 0.41-0.81, p = 0.002), but had significantly higher odds of having high LDL-C levels (OR: 1.50, 95% CI: 1.02-2.22, p = 0.04), as compared to those with low physical activity. The multiple linear regression model revealed that moderate and high activity level was positively associated with higher EQ-5D index scores (β = 0.05, p < .001) as compared to low activity levels in respondents with multimorbidity. Conclusions: The low levels of physical activity among patients with multimorbidity, and its association with overweight status and poorer HRQoL emphasizes the importance of increasing physical activity in this population. Family physicians treating patients with chronic diseases need to continue encouraging and helping individuals to initiate and maintain appropriate physical activity levels.

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Section: Introductionmentioning

confidence: 94%

Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population

Subramaniam¹,

Zhang²,

Lau³

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…The cumulative effects of multiple chronic conditions on an individual are complex; specific combinations of conditions may have greater effects on functional status, quality of life (QoL), and mortality than others [ 9 , 10 ]. Several studies have shown that multimorbidity is significantly associated with poor HRQoL in adult patients [ 11 – 13 ]. However, little is known about multimorbid patients’ self-perceived HRQoL in comparison with the general population and in different multimorbid patient age groups.…”

Section: Introductionmentioning

confidence: 99%

Comparing the self-perceived quality of life of multimorbid patients and the general population using the EQ-5D-3L

et al. 2017

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ObjectivesTo assess and compare the self-perceived Health Related Quality of Life (HRQoL) of multimorbid patients and the general population using health utilities (HU) and visual analogue scale (VAS) methods.MethodsWe analyzed data (n = 888) from a national, cross-sectional Swiss study of multimorbid patients recruited in primary care settings. Self-perceived HRQoL was assessed using the EQ-5D-3L instrument, composed of 1) a questionnaire on the five dimensions of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression (EQ-5D dimensions), and 2) a 0–100 (0 = worst- and 100 = best-imaginable health status) VAS. We described the EQ-5D dimensions and VAS and computed HU using a standard pan-European value set. HU and VAS are the two components of the overall HRQoL assessment. We examined the proportions of multimorbid patients reporting problems (moderate/severe) in each EQ-5D dimension, corresponding proportions without problems, and mean HU and VAS values across patient characteristics. To test differences between subgroups, we used chi-square tests for dichotomous outcomes and T-tests (ANOVA if more than two groups) for continuous outcomes. Finally, we compared observed and predicted HU and VAS values.ResultsAll 888 participants answered every EQ-5D item. Mean (SD) HU and VAS values were 0.70 (0.18) and 63.2 (19.2), respectively. HU and VAS were considerably and significantly lower in multimorbid patients than in the general population and were also lower in multimorbid patients below 60 years old and in women. Differences between observed and predicted means (SD) were -0.07 (0.18) for HU and -11.8 (20.3) for VAS.ConclusionsSelf-perceived HRQoL is considerably and significantly affected by multimorbidity. More attention should be given to developing interventions that improve the HRQoL of multimorbid patients, particularly women and those aged below 60 years old.

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“…2 Thus, we used a list of 14 chronic conditions to de ne multimorbidity: diabetes mellitus, hypertension, lipid disorder, neurological conditions, respiratory diseases, psychiatric conditions, cancer, chronic kidney disease, heart diseases, arthritis, back/neck problems, gastrointestinal diseases, thyroid disease and physical disability. This list was previously used by Quah et al 16 to measure multimorbidity in elderly patients at a primary healthcare setting and was derived from the Singapore Mental Health Study. 30 Participants were asked to report if they had any of the chronic conditions listed above, as told to them by a registered physician.…”

Section: De Nition Of Multimorbiditymentioning

confidence: 99%

How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

Sim¹,

Koh²,

Lee³

et al. 2020

Preprint

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Background: Multimorbidity is of increasing prevalence and importance. It has been negatively associated with health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity for the middle-aged population, defined as those between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore.Methods: A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses.Results: The study included 297 participants, aged 40-64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient -0.064 (C.I -0.125, -0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient -0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort.Conclusion: Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population.

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Health‐related quality of life of older Asian patients with multimorbidity in primary care in a developed nation

Cited by 43 publications

References 20 publications

Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population

Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population

Comparing the self-perceived quality of life of multimorbid patients and the general population using the EQ-5D-3L

How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

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