PIH44 Health-Related Quality of Life for Patients with Chronic Conditions: Revealing the Profile of Burden Associated with Co-Morbid Physical and Mental Conditions in Respondents from Five European Countries

Abstract

Studies often examine the impact of specific chronic conditions (CC) in isolation or in conjunction with another specific CC. Our aims were to compare: 1) the effect of physical CCs (PCC) in addition to mental CCs (MCC) to the effect of PCCs only; 2) the effect of MCCs in addition to PCCs to the effect of MCCs only; and 3) effects across country. Data from the 2010 EU National Health and Wellness Survey were used (N=57,805; France, Germany, Italy, Spain, and the UK). Respondents were categorized as: ‘Healthy' (no mental or physical CC); ‘Physical' (physician indicated 1+ physical but no mental CCs); ‘Mental' (physician indicated 1+ mental but no physical CCs); ‘Physical and Mental' (1+ mental and 1+ physical CCs). Differences across groups were assessed using multivariate regression with SF-12v2® Health Survey summary measures (PCS & MCS) as outcomes and controlling for age and gender. Relative to ‘Healthy' respondents, the presence of 1+ PCC was associated with a significant decrement in both PCS (-3.04 to -5.18, p<.05) and MCS (-1.23 to -2.53, p<.05). The presence of 1+ mental condition was also associated with decreased MCS (-7.10 to -13.30, p<.05) and PCS (-1.23 to -2.53, p<.05). Interestingly, the impact of co-morbid conditions, physical or mental, varied as a function of other existing conditions (physical or mental). The impact of adding 1+ PCC to an existing MCC was associated with a larger decrement in PCS (-4.34 to -6.92, p<.05) and MCS (-8.54 to -11.70, p<.05) as compared to adding 1+ PCC to those who were healthy. Results were consistent across gender and country. These findings (which are largely consistent an earlier US study) highlight the complexity of managing patients with co- or multi-morbid CCs as the measurable burden of CCs varies with the presence of other conditions.