Abstract
BackgroundThis study was carried out to compare the HRQoL of patients in general practice with differing chronic diseases with the HRQoL of patients without chronic conditions, to evaluate the HRQoL of general practice patients in Germany compared with the HRQoL of the general population, and to explore the influence of different chronic diseases on patients' HRQoL, independently of the effects of multiple confounding variables.MethodsA cross-sectional questionnaire survey including the SF-36, the EQ-5D and demographic questions was conducted in 20 general practices in Germany. 1009 consecutive patients aged 15–89 participated. The SF-36 scale scores of general practice patients with differing chronic diseases were compared with those of patients without chronic conditions. Differences in the SF-36 scale/summary scores and proportions in the EQ-5D dimensions between patients and the general population were analyzed. Independent effects of chronic conditions and demographic variables on the HRQoL were analyzed using multivariable linear regression and polynomial regression models.ResultsThe HRQoL for general practice patients with differing chronic diseases tended to show more physical than mental health impairments compared with the reference group of patients without. Patients in general practice in Germany had considerably lower SF-36 scores than the general population (P < 0.001 for all) and showed significantly higher proportions of problems in all EQ-5D dimensions except for the self-care dimension (P < 0.001 for all). The mean EQ VAS for general practice patients was lower than that for the general population (69.2 versus 77.4, P < 0.001). The HRQoL for general practice patients in Germany seemed to be more strongly affected by diseases like depression, back pain, OA of the knee, and cancer than by hypertension and diabetes.ConclusionGeneral practice patients with differing chronic diseases in Germany had impaired quality of life, especially in terms of physical health. The independent impacts on the HRQoL were different depending on the type of chronic disease. Findings from this study might help health professionals to concern more influential diseases in primary care from the patient's perspective.
Highlights
This study was carried out to compare the Health-related quality of life (HRQoL) of patients in general practice with differing chronic diseases with the HRQoL of patients without chronic conditions, to evaluate the HRQoL of general practice patients in Germany compared with the HRQoL of the general population, and to explore the influence of different chronic diseases on patients' HRQoL, independently of the effects of multiple confounding variables
We found that general practice patients in Germany had considerably lower scale scores and component summary scores for the social functioning (SF)-36 and higher proportions reporting any problems in all EQ-5D dimensions except for the self-care dimension, compared with the general population
When we controlled for demographic variables such as age, gender, marital status, employment status, smoking, educational attainment, academic degree or qualification, medical insurance, and self-reported severe illness experience, we found that OA of the knee and back pain predicted of a lower SF-36 PCS score, depression predicted of a lower SF-36 MCS score, and that depression and cancer were risk factors for the EQ VAS score
Summary
This study was carried out to compare the HRQoL of patients in general practice with differing chronic diseases with the HRQoL of patients without chronic conditions, to evaluate the HRQoL of general practice patients in Germany compared with the HRQoL of the general population, and to explore the influence of different chronic diseases on patients' HRQoL, independently of the effects of multiple confounding variables. Health information related to patients outside primary care is not comparable to patients in this setting [4]. The HRQoL of patients with one single chronic disease has been explored in primary care [5,6,7]. Newly diagnosed patients with Type 2 diabetes in general practice compared with screeningdetected patients reported more diabetes-related symptom distress shortly after the diagnosis, and a consistently worse mental health status at 6 months and 12 months [7]. Most studies on the HRQoL of patients with chronic diseases in the primary care setting are focused on one chronic disease in particular. Systematic investigations into the independent influence of the multiple chronic diseases in primary care are still limited
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