Chronic conditions, multimorbidity, and quality of life among patients attending monk healers and primary care clinics in Thailand

Supa Pengpid,Karl Peltzer

doi:10.1186/s12955-021-01707-x

Abstract

BackgroundThe study aimed to assess chronic diseases, multimorbidity, and QoL among patients attending two different treatment settings in Thailand.MethodsIn all, 1409 attendees of three monk healer or three health centres were assessed with self-reported measures on chronic conditions and Quality of Life (QoL).ResultsResults indicate that the most common chronic conditions were common mental disorder (25.2%), followed by hypertension (22.8%), high blood cholesterol (18.0%), fatigue disorder (14.4%), diabetes (14.0%), migraine headaches (13.7%), sleeping problem (12.2%), and ulcer (11.0%). In all, 40.6% had multimorbidity (two or more chronic conditions) (42.4% in the monk healer and 38.9% in the primary care setting). In ANCOVA analysis, adjusted for sex, age, employment status, marital status, education, economic status, comorbidity, and health care setting, the poorest overall QoL was found among clients with common mental disorders (58.5 mean score), followed by emphysema or asthma (60.2), sleeping problem (61.5), migraine headaches (62.7), fatigue disorder (63.3), substance use disorder (63.6) and ulcer (64.3). The overall QoL was poorer among monk healer clients (66.5) than primary care patients (68.8). In adjusted logistical regression analysis, being a monk healer attendee, older age (55–93 years), and high debt were positively, and being employed and better overall quality of life were negatively associated with multimorbidity, overall, for the monk healer and primary care setting. In adjusted linear regression analyses, primary health care attenders, older age, were employed and post-secondary education increased the odds of better overall QoL.ConclusionMultimorbidity was higher among clients attending monk healers than those attending primary care facilities and QoL was poorer among clients seeking care from monk healers than those attending primary care. High multimorbidity was found and major chronic conditions were found to have poor QoL. Determinants of multimorbidity and QoL in two different treatment settings provide information to improve the management of chronic conditions.

Highlights

The study aimed to assess chronic diseases, multimorbidity, and Quality of Life (QoL) among patients attending two different treatment settings in Thailand
The prevalence of emphysema or asthma, osteoporosis, cancer, substance use disorders, heart attack or stroke, common mental disorders, sore joints, and sleeping problems was higher among monk healer attendees, while the prevalence of diabetes and hypertension was higher in primary care attendees
Quality of Life in chronic conditions and multimorbidity In Analysis of covariance (ANCOVA) analysis, adjusted for sex, age, employment status, marital status, education, economic status, comorbidity, and health care setting, the poorest overall QoL was found among clients with common mental disorders (58.5 mean score), followed by emphysema or asthma (60.2), sleeping problem (61.5), migraine headaches (62.7), fatigue disorder (63.3), substance use disorder (63.6) and ulcer (64.3)

Summary

Introduction

The study aimed to assess chronic diseases, multimorbidity, and QoL among patients attending two different treatment settings in Thailand. In a study among chronic disease primary care patients in four Greater Mekong countries, the majority (72.6%) had multimorbidity [1]. In Singapore, among adult patients with chronic diseases in public sector primary care clinics, 39.6% of those who had used traditional and complementary medicine (TCM) in the past year and 28.1% who had not used (TCM) had multimorbidity [4]. Several studies [4,5,6,7], including in Cambodia, Thailand, Singapore, USA, and Vietnam, showed that patients with multimorbidity are more likely to utilize traditional and complementary medicine (TCM) than patients without multimorbidity. It is hypothesized that attendees of THP (monk healer) have a higher prevalence of multimorbidity than primary care attendees. Monk healers are Thai THP providing various types of treatments, including herbal medicine, physical therapy, and Buddhist practices, such as prayer [10, 11]

Methods

Results

Discussion

Conclusion