Effects Of Chronic Conditions Research Articles

THE EFFECT OF CHRONIC CONDITIONS ON DEPRESSIVE SYMPTOMS IS MODERATED BY SEXUAL MINORITY STATUS

Abstract It is important to examine disparities in the effects of physical health on depression among sexual minority (SM) older adults. We examined whether the effects of chronic conditions (CCs) and self-rated health (SRH) on depressive symptoms were moderated by sexual orientation among 3,741 adults aged 50+ (SM = 216) who participated in the 2016 wave of the Health and Retirement Study (HRS) and responded to the recently added sexual orientation item. Structural equation modeling was used to model the effects of SRH and CCs on depressive symptoms, while controlling for participant sex, age, years of education, net-worth, and race/ethnicity. Greater numbers of CCs were associated with greater depressive symptoms (b= .24, SE = .04, p <.001), whereas better SRH was associated with fewer depressive symptoms (b = -.60, SE = .05, p <.001). The direct effect of SM on depressive symptoms was significant, b = 1.14, SE = .48, p =.02, indicating greater depressive symptoms among SM adults. The interaction between SM and SRH on depressive symptoms was significant (b = -.39, SE = .17, p = .02). The same effect was seen for CCs (b = -.32, SE = .15, p = .04). Simple slopes revealed that for heterosexual older adults, greater CCs were associated with greater depressive symptoms (b = .27, SE = .04, p <.001), however this association was not significant for SM older adults (b = -.05, SE = .16, p = .75). Future research should examine health disparities among SMs in relation to mental health.

N16 ‘Sex? Don’t even remember what that is …’ exploring IBD patient engagement with online forums regarding the topics of relationships and intimacy

Abstract Background Online forums available to those living with Inflammatory Bowel Disease (IBD) are a platform enabling peer support. Some use online forums to discuss sensitive issues, such as the effect of chronic conditions on their intimate and sexual lives. This study explored the common topics regarding relationships and intimacy with IBD that are discussed on online forums. Methods This study collected anonymous data available from a public domain (online forum) and analysed it using Braun and Clarke’s thematic analysis. Data were collected from 15 threads discussing topics relating to IBD and relationships from 2008 to 2016. In total, it involved around 144 people engaged in group conversations on the topics. No subscription was needed to access the data, and all participants used pseudonyms. Results Two themes were developed from analysing online forum engagement on sensitive topics: Relationships and IBD and ‘ Sex? What’s that?’ . The most prevalent discussions were around broken-down relationships: ‘The guy I was dating when I was diagnosed broke up with me 6–8 months later, in large part because of how the disease was changing my life’. There were many concerns about the right time for disclosure of illness whilst dating: ‘I feel like 5 dates/one months was definitely the right time. It’s not first date material.’ Participants actively sought others’ intimate experiences for advice and found consolation in sharing common experiences, particularly regarding symptoms affecting sex:’ Intimacy and Crohn’s can be an awful combination’, or relationships: ‘I am dating two! My iPad and my UC! Neither snore, but both are very needy!’ Participants also expressed their findings of comfort from hearing others experiences online: ‘This thread gives us hope though that it is possible to be with someone with this disease’. Additionally, sexual minority groups can also feel that they have a platform where they can discuss sexuality without prejudice and easily access others of the same sexual orientation when asking for advice. Conclusion IBD patients use online forums to discuss their intimate lives when looking for help from others experiencing a similar situation or looking for acceptance. This suggests patients may feel embarrassed talking about sex and may not see their health care professionals as the first port of call for questions about intimacy, highlighting the importance of online forums in seeking peer support for such topics. Further research is recommended to understand how patients might prefer to express their worries in an anonymous, safe environment.

Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socio-economic status, Barcelona, Spain, 24 February to 4 May 2020

BackgroundPopulation-based studies characterising outcomes of COVID-19 in European settings are limited, and effects of socio-economic status (SES) on outcomes have not been widely investigated. AimWe describe the epidemiological characteristics of COVID-19 cases, highlighting incidence and mortality rate differences across SES during the first wave in Barcelona, Catalonia, Spain.MethodsThis population-based study reports individual-level data of laboratory-confirmed COVID-19 cases diagnosed from 24 February to 4 May 2020, notified to the Public Health Agency of Barcelona and followed until 15 June 2020. We analysed end-of-study vital status and the effects of chronic conditions on mortality using logistic regression. Geocoded addresses were linked to basic health area SES data, estimated using the composed socio-economic index. We estimated age-standardised incidence, hospitalisation, and mortality rates by SES.ResultsOf 15,554 COVID-19-confirmed cases, the majority were women (n = 9,028; 58%), median age was 63 years (interquartile range: 46–83), 8,046 (54%) required hospitalisation, and 2,287 (15%) cases died. Prevalence of chronic conditions varied across SES, and multiple chronic conditions increased risk of death (≥ 3, adjusted odds ratio: 2.3). Age-standardised rates (incidence, hospitalisation, mortality) were highest in the most deprived SES quartile (incidence: 1,011 (95% confidence interval (CI): 975–1,047); hospitalisation: 619 (95% CI: 591–648); mortality: 150 (95% CI: 136–165)) and lowest in the most affluent (incidence: 784 (95% CI: 759–809); hospitalisation: 400 (95% CI: 382–418); mortality: 121 (95% CI: 112–131)).ConclusionsCOVID-19 outcomes varied markedly across SES, underscoring the need to implement effective preventive strategies for vulnerable populations.

The impact of common chronic conditions on health-related quality of life: a general population survey in Iran using EQ-5D-5L

BackgroundDiseases have undeniable effects on Health-Related Quality of Life (HRQoL). Chronic diseases, in particular, limit the productive potentials and HRQoL of individuals. EQ-5D is a very popular generic instrument, which can be used to estimate HRQoL scores in any diseases. The current study investigates mean HRQoL scores in certain chronic diseases and examines the relationship between utility scores and chronic diseases in Iran.MethodThis cross-sectional study was carried out among the general adult population of Tehran. 3060 individuals were chosen by a stratified probability sampling method. The EQ-5D-5L questionnaire was applied. The utility scores were estimated using the Iranian crosswalk-based value set. The effect of chronic diseases on the HRQoL scores was derived by the Ordinary Least Squares (OLS) method. Data was analyzed using Stata version 13 software.ResultsThe mean ± standard deviation utility and EQ-VAS scores were 0.85 ± 0.14 and 76.73 ± 16.55 in the participants without any chronic conditions. The scores were 0.69 ± 0.17 and 61.14 ± 20.61 in the participants with chronic conditions. The highest and lowest mean utility scores were related to thyroid disease (0.70) and Stroke (0.54), respectively. Common chronic conditions had significant negative effects on the HRQoL scores. Stroke (0.204) and cancer (0.177) caused the most reduction in the EQ-5D-5L utility scores. Lumbar disc hernia, digestive diseases, osteoarthritis, breathing problems, and anxiety/nerves cause 0.133, 0.109, 0.108, 0.087, and 0.078 reductions, respectively, in the EQ-5D-5L utility scores.ConclusionThis study provides insight into some common chronic conditions and their effects on the HRQoL. Policymakers and planners should pay attention to the effects of chronic conditions especially high prevalence one. They should adopt effective interventions to control this issue and increase health. The results of this study can also be beneficial in economic evaluation studies.

Mortality analysis of alcohol consumption using a hybrid machine learning model

The day-to-day change and evolution of chronic conditions had a high impact on the medical field. Alcohol consumption is also another important and considerable cause of the occurrence of various chronic conditions. Generally, the data that is being collected during the diagnosis can be represented in various forms such as clinical values, reports, images, etc. There is a dire need of analysing this data to let the people and health centres/institutions knowledgeable about the criticality and effect of chronic conditions. This work mainly focuses on the analysis of the mortality rate that occurs due to alcohol consumption. To achieve this, K-means clustering with linear regression technique is proposed. The linear regression model is constructed to forecast the analysis of consumers on the whole. The simulation results evaluate the model and it is observed that the coefficient of determination exhibits that the constructed model is found to be fitting precisely.

The Effects of Social Participation Restriction on Psychological Distress among Older Adults with Chronic Illness

ABSTRACT This study examined how restricted social participation mediates the relationship between chronic illness and psychological distress among community-dwelling older adults. Additionally, the use of the Internet for health care was tested as a moderator to examine whether the relationship between limited social participation and psychological distress differs. Using the multiple-group path analysis approach, 16,032 community-dwelling older adults (65+) from the National Health Interview Survey were analyzed. The findings show that 32.2% suffered from chronic illnesses that limited their daily activities, and 26% reported social participation restrictions to some degree. While having chronic illnesses was associated with greater psychological distress, the association was also through increased social participation restriction (mediation). Furthermore, differences in mediation were found between health information technology users and nonusers (moderated mediation). In contrast to the hypothesis, the adverse relationship between limited social participation and psychological distress was stronger among users, although chronic conditions were associated with greater social participation restrictions among nonusers. The findings suggest that with proper accommodations and interventions that aim to increase the social participation of community-dwelling older adults, the disadvantageous effects of chronic conditions on psychological distress could be ameliorated. Moreover, the importance of such interventions is greater among health information technology users.

Colchicine as a Potential Therapeutic Agent Against Cardiovascular Complications of COVID-19: an Exploratory Review.

Coronavirus disease-19 (COVID-19) may result in serious complications involving several organ systems, including myocardial tissue. An exaggerated host inflammatory response, described as a cytokine storm, has been linked to play a major role in these complications. Colchicine and other pharmaceutical agents have been proposed to counter the cytokine storm and improve outcomes. In this exploratory review, we utilized a PubMed and Cochrane Database search aiming to identify the biochemical characteristics of the cytokine storm as well as to identify the potential effect of colchicine on these inflammatory biomarkers. The research yielded 30 reports describing the characteristics of the cytokine storm and 44 reports describing the effect of colchicine on various inflammatory biomarkers. According to our research, colchicine may be an agent of interest in the treatment of COVID-19 via its anti-inflammatory properties. However, there are potential drug interactions with cytochrome P450 3A4 inhibitors resulting in acute colchicine toxicities. Additionally, there is scarce evidence regarding the efficacy of colchicine in the acute phase of disease, since most trials evaluated its effect in chronic conditions. In this direction, our team proposes three different hypotheses for evaluating the place of colchicine in the treatment of COVID-19.

Crosstalk between the Producers and Immune Targets of IL-9.

IL-9 has been reported to play dual roles in the pathogenesis of autoimmune disorders and cancers. The collaboration of IL-9 with microenvironmental factors including the broader cytokine milieu and other cellular components may provide important keys to explain its conflicting effects in chronic conditions. In this review, we summarize recent findings on the cellular sources of, and immunological responders to IL-9, in order to interpret the role of IL-9 in the regulation of immune responses. This knowledge will provide new perspectives to improve clinical benefits and limit adverse effects of IL-9 when treating pathologic conditions.

CHRONIC CONDITIONS, FUNCTIONAL LIMITATIONS, AND DEPRESSION IN OLDER ADULTS: ANALYSIS OF A LONGITUDINAL STUDY

Background: Chronic conditions, functional limitations, and depression are highly prevalent in older adults. Evidence suggests the links between chronic conditions, functional limitations, and depressive symptoms separately. However, few studies have considered these three conditions together longitudinally. This study examined the longitudinal relationship between chronic conditions and depressive symptoms and evaluated the mediation effect of functional limitations on the relationship between chronic conditions and depressive symptoms in older adults. Methods: This study analyzed longitudinal data from the Health and Retirement Study collected in 2012 and 2014. Mediation analysis was used to examine the direct and indirect effects of chronic conditions and functional limitations measured at the year 2012 on depressive symptoms measured at the year 2014 controlling for demographics. Results: Results revealed that chronic conditions predicted depressive symptoms. Specifically, one additional chronic condition in 2012 corresponded to an increase of 0.35 in depressive symptoms in 2014 (p<.001). After adding functional limitations as a mediator, the direct effect was reduced to 0.26 and the indirect effect was .088 (p<.001). In other words, functional limitations explained approximately 25% of the direct effect of chronic diseases on depression. Discussion: Findings reveal the longitudinal impact of chronic conditions and functional limitations on depressive symptoms in older adults. Findings help identify the high-risk population of depressive symptoms and intervene early.

Conjugated linoleic acid and betaine affect lipolysis in pig adipose tissue explants

Consumers’ demand of leaner meat products is a challenge. Although betaine and conjugated linoleic acid (CLA) have the potential to decrease porcine adipose tissue, their mode of action is poorly understood. The aim of the study was to determine the lipolytic effect of betaine and CLA in the adipose tissue of Iberian pigs. Adipose tissue explants from five pigs (38 kg BW) were prepared from dorsal subcutaneous adipose tissue samples and cultivated for 2 h (acute experiments) or 72 h (chronic experiments). Treatments included 100 µM linoleic acid (control), 100 µM trans-10, cis-12 CLA, 100 µM linoleic acid + 1 mM betaine and 100 µM trans-10, cis-12 CLA + 1 mM betaine (CLABET). To examine the ability of betaine or CLA to inhibit insulin’s suppression of isoproterenol-stimulated lipolysis, test medium was amended with 1 µM isoproterenol ±10 nM insulin. Media glycerol was measured at the end of the incubations. Acute lipolysis (2 h) was increased by CLA and CLABET (85% to 121%; P < 0.05) under basal conditions. When lipolysis was stimulated with isoproterenol (1090%), acute exposure to betaine tended to increase (13%; P = 0.071), while CLA and CLABET increased (14% to 18%; P < 0.05) isoproterenol-stimulated lipolysis compared with control. When insulin was added to isoproterenol-stimulated explants, lipolytic rate was decreased by 50% (P < 0.001). However, supplementation of betaine to the insulin + isoproterenol-containing medium tended to increase (P = 0.07), while CLABET increased (45%; P < 0.05) lipolysis, partly counteracting insulin inhibition. When culture was extended for 72 h, CLA decreased lipolysis under basal conditions (18%; P < 0.05) with no effect of betaine and CLABET (P > 0.10). When lipolysis was stimulated by isoproterenol (125% increase in rate compared with basal), CLA and CLABET decreased glycerol release (27%; P < 0.001) compared with control (isoproterenol alone). When insulin was added to isoproterenol-stimulated explants, isoproterenol stimulation of lipolysis was completely blunted and neither betaine nor CLA altered the inhibitory effect of insulin on lipolysis. Isoproterenol, and especially isoproterenol + insulin, stimulated leptin secretion compared with basal conditions (68% and 464%, respectively; P < 0.001), with no effect of CLA or betaine (P > 0.10). CLA decreased leptin release (25%; P < 0.001) when insulin was present in the media, partially inhibiting insulin stimulation of leptin release. In conclusion, betaine and CLA produced a biphasic response regarding lipolysis so that glycerol release was increased in acute conditions, while CLA decreased glycerol release and betaine had no effect in chronic conditions. Furthermore, CLA and CLABET indirectly increased lipolysis by reducing insulin-mediated inhibition of lipolysis during acute conditions.

The effect of chronic conditions and multi-morbidity on self-assessed health in Russia.

Chronic disorders, such as cardiovascular disease, cancer, respiratory diseases and diabetes, are the leading cause of mortality globally, representing 68% of all recorded deaths. The incidence of chronic disease and multiple chronic disease is rising across the world, but relatively little is known about the impact of multi-morbidities on the life experiences of those individuals who encounter them. In this paper, we examine and quantify the relationship between chronic illness, multi-morbidity and the individual self-assessed health of the Russian population using individual-level Russian data and a novel quantitative technique. We apply a partial proportional odds framework to a rich data set incorporating demographic, socio-economic and health indicators in Russia. We find that individuals with chronic conditions report significantly lower levels of health than those without chronic conditions, but that the strength of the effect is much more pronounced for males than for females (e.g. neurological disease: odds ratio [OR]=4.81 for men; OR=1.86 for women)). As the number of co-morbidities increases, there is a dramatic decrease in the likelihood of reporting good health for both males and females, but for males there is a greater increase in the likelihood of reporting bad health (OR=49.31 for males with ≥5 diseases; OR=28.05 for females). More than 40% of Russians currently live with multi-morbidity, and this group is at the highest risk of reporting poor self-rated health. This research adds to the body of evidence demonstrating the challenges facing health-care systems as new patterns of disease take hold in contemporary society.

The economic burden of noncommunicable diseases and mental health conditions: results for Costa Rica, Jamaica, and Peru.

ABSTRACTObjectiveWe extend the EPIC model of the World Health Organization (WHO) and apply it to analyze the macroeconomic impact of noncommunicable diseases (NCDs) and mental health conditions in Costa Rica, Jamaica, and Peru.MethodsThe EPIC model quantifies the impact of NCDs and mental health conditions on aggregate output solely through the effect of chronic conditions on labor supply due to mortality. In contrast, the expanded EPIC-H Plus framework also incorporates reductions in effective labor supply due to morbidity and negative effects of health expenditure on output via the diversion of productive savings and reduced capital accumulation. We apply this methodology to Costa Rica, Jamaica, and Peru and estimate gross domestic product (GDP) output lost due to four leading NCDs (cardiovascular disease, cancer, chronic respiratory disease, and diabetes) and mental health conditions in these countries from 2015 to 2030. We also estimate losses from all NCDs and mental health conditions combined.ResultsOverall, our results show total losses associated with all NCDs and mental health conditions over the period 2015–2030 of US$ 81.96 billion (2015 US$) for Costa Rica, US$ 18.45 billion for Jamaica, and US$ 477.33 billion for Peru. Moderate variation exists in the magnitude of the burdens of diseases for the three countries. In Costa Rica and Peru, respiratory disease and mental health conditions are two leading contributors to lost output, while in Jamaica, cardiovascular disease alone accounts for 20.8% of the total loss, followed by cancer.ConclusionsThese results indicate that the economic impact of NCDs and mental health conditions is substantial and that interventions to reduce the prevalence of chronic conditions in countries of Latin America and the Caribbean are likely to be highly cost-beneficial.

Acute Intermittent Porphyria in the North of China: The Acute Attack Effect on Quality of Life and Psychological Condition.

Background Acute intermittent porphyria (AIP) is an autosomal recessive disorder with intermittent attacks. Patients with AIP are susceptible to impaired quality of life and psychological distress. Objectives To document the clinical features of AIP and its impact on SF-36 and IES scores of AIP patients in China and to explore the variables associated with SF-36 and IES scores. Methods A single investigator collated data related to treatments and outcomes in 27 patients with AIP of PUMCH. A cross-sectional questionnaire survey including the SF-36, the IES-R, and demographic questions was conducted in the north of China. Differences in the QoL scale/summary scores and proportions in the QoL dimensions between patients and the general population were analyzed. Independent effects of chronic conditions and demographic variables on the SF-36 and IES-R were analyzed. Results AIP patients had considerably lower SF-36 scores than the general population (the PF score and MH were lower than normal, P < 0.05). Working had higher RP than staying at home (P = 0.02); “without acute attack” had higher PF and BP scores and PCS composite score (P = 0.001). The mean IES-R score of AIP was higher than normal (36.7 ± 11.8 points, P < 0.001), “without acute attack” had lower intrusion score than “with acute attack” (P = 0.03). Conclusion AIP patients in China had impaired quality of life, especially in terms of physical health. The acute attacks coursed the posttraumatic stress disorder-related symptoms.

Longitudinal changes in mobility among nonagenarians: the Vitality 90+ Study.

BackgroundSeveral studies have focused on predictors of mobility limitations and disabilities. Yet little is known about the pace and patterns of mobility changes among very old people. This study examined changes in functional mobility among individuals aged 90 years and older during a 2-9-year follow-up. In addition, we were interested in the patterns of mobility changes.MethodsData were collected through a mailed questionnaire in the years 2001, 2003, 2007 and 2010. The study population (n = 948) consisted of individuals from three cohorts (2001, 2003, 2007) who participated in at least two survey rounds and answered the mobility questions. The length of the follow-up varied from 2–9 years between individuals as well as according to how many times an individual took part in the survey. Multilevel ordinal logistic regression analysis was used to evaluate the effects of time, age, gender, cohort and chronic conditions on changes in mobility.ResultsAt the baseline, “younger” old people, men and individuals in the cohorts for 2003 and 2007 had significantly better mobility compared with women, older individuals and individuals in the 2001 cohort. In addition, individuals with fewer chronic conditions had better mobility than those with more diseases. Mobility declined for most of the participants during the follow-up. The difference in the change in mobility over time for gender, age or chronic conditions was not statistically significant. The analyses were performed with a subgroup of participants aged 90–91 years at the baseline, and results did not differ substantially from the results for the entire study sample. However, the effect of chronic conditions on the change in mobility was statistically significant among participants aged 90-91years.ConclusionsNo differences were observed in the rate of mobility decline over time between age or gender. The effect of chronic conditions on the change in mobility was significant only among individuals aged 90–91 years. The prevention efforts are important and should focus even more, also among the oldest-old, on additional modifiable risk factors such as maintaining muscle strength.

The Influence of the Common Cold on Self-Rated Health: A Population-Based Study.

ObjectiveStudies on the association between self-rated health and acute conditions are sparse. The aim of this study was to examine whether individuals respond to acute conditions (such as the common cold) in health ratings as well as the effect of chronic conditions (using the Charlson comorbidity score) on self-rated health.MethodsThe national representative survey data was linked with the claims data from the Taiwan National Health Insurance for 13,723 adults ≥ 18 years. Ordered logistic regressions with fractional polynomials were estimated to determine the relationship between the frequency of common cold episodes and the Charlson comorbidity score on self-rated health. The interactions between these two variables and the baseline age were tested.ResultsSelf-rated health worsens with the increased frequency of both common cold episodes and the Charlson comorbidity score. Both variables have a non-linear relationship with self-rated health. Younger individuals put heavier weight on acute health conditions than their older counterparts.ConclusionIndividuals respond to questions regarding their self-rated health based on their acute health condition along with chronic condition. Thus the information on self-rated health depends on the timing the information is collected, and whether at that time the individual experienced acute health conditions or not.

Medicare payments: how much do chronic conditions matter?

Analyze differences in Medicare Fee-for-Service utilization (i.e., program payments) by beneficiary characteristics, such as gender, age, and prevalence of chronic conditions. Using the 2008 and 2010 Chronic Conditions Public Use Files, we conduct a descriptive analysis of enrollment and program payments by gender, age categories, and eleven chronic conditions. We find that the effect of chronic conditions on Medicare payments is dramatic. Average Medicare payments increase significantly with the number of chronic conditions. Finally, we quantify the effect of individual conditions and find that "Stroke / Transient Ischemic Attack" and "Chronic Kidney Disease" are the costliest chronic conditions for Part A, and "Cancer" and "Chronic Kidney Disease" are the costliest for Part B.

Aging with an existing physical disability

Significant advances in medical technology and increasing social and environmental supports throughout communities now allow persons with even severe disabilities to live into late-middle and old age. Disabilities are diverse, ranging from cognitive to mental health to sensory to physical impairments. Each different type of disability has specific implications for the experience of aging; notably, many persons have more than one type of impairment, complicating matters. In the United States, 54 million persons currently live with disabilities, and the numbers with grow substantially with the aging baby boomers as persons become newly disabled by the consequences of chronic conditions. This talk, however, focuses on persons with physical disabilities who either have had their disability since birth or who acquired their disability during childhood or by middle age. Persons aging with a physical disability confront threats to their functional abilities on four broad levels: (1) progression of their underlying disability; (2) development of secondary conditions (i.e., other conditions related to or as complications of their disabling condition); (3) development of comorbid chronic conditions associated with aging (i.e., conditions not related in etiology to the underlying disability); and changes in social, socioeconomic, and physical environments (e.g., widowhood, retirement from work, fixed income, downsizing home, becoming unable to drive). This talk with explore each of these four dimensions, looking first at the nature and epidemiology of the concerns and then drawing upon stories from research interviews and the literature to highlight the personal dimensions of aging with a physical disability.

The effect of chronic conditions on stated preferences for health

While patients tend to value their own health state systematically higher than others would rate it, it is less clear whether stated preferences for hypothetical health states differ between persons with and without specific medical conditions. The aim of this study was to determine if specific conditions affect the valuation of health using a generic measure. Using data from the US Valuation of EQ-5D Health States (n=3,773), we focused on six conditions of interest (COI), e.g., arthritis, diabetes, depression, heart failure, cancer, and hay fever, and time trade-off values for 12 of 243 EQ-5D health states. For each COI, regression models compared differences in pooled health state preferences among four groups: COI, COI plus one or more additional conditions, no COI but other conditions, or no chronic conditions. No differences in health state preferences were found among the four groups for any of the COIs except for patients with cancer and additional conditions, whose mean scores were 0.07 lower compared to no chronic conditions (P<0.01). The strongest predictors of health state preferences were race/ethnicity, age, and marital status. Most self-reported chronic conditions had a trivial impact on preferences for hypothetical health states, which suggests that utility algorithms for generic preference-based measures will be similar when estimated from preferences of the general population or patients with chronic illness, conceivably because both types of respondents have not experienced many health states in the classifier system.

O1-3.5 Can we intervene to promote capability and well-being?

Chronic conditions are common in the older population and the co-occurrence of multiple conditions increases with increasing age. Ultimately, the consequences of chronic conditions, particularly functional consequences, play a critical...

An evaluation of the effects of chronic diseases and health conditions on tobacco cessation

Objective: This study examined the effects of chronic health conditions on tobacco cessation and participation in a follow-up assessment among 13,900 smokers in a telephone-based tobacco cessation programme. Design: This study involved gathering data from individuals during pre- and post-intervention telephonic assessments following their decision to participate in the tobacco cessation wellness programme. Setting: The study sample included participants from across the United States, with a large concentration living in the Midwestern region. Method: The study sample was limited to participants who were eligible to receive three-month, six-month, and 12-month follow-up calls. Logistic regressions were used to allow an estimate of the impact of chronic conditions while holding constant other factors such as age, readiness, and confidence. Results: The results suggest that the presence of certain chronic conditions was associated with a reduced likelihood of quitting smoking. The presence of chronic conditions did not influence the likelihood that participants completed the follow-up assessment. Interestingly, the effect of chronic conditions on cessation was only slightly higher than the impact of gender. The four-point difference warrants further investigation, especially considering the higher rates of depression in women. Conclusion: This study supports prior research that the presence of one or more chronic conditions has a negative effect on the ability to cease tobacco use. More customized programmes are required to overcome the significant effect of gender, the presence of certain chronic conditions such as depression, and the impact of follow-up calls on cessation success.