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Health and Quality of Life Outcomes

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Open Access 01-12-2004 | Review

Multimorbidity and quality of life in primary care: a systematic review

Authors: Martin Fortin, Lise Lapointe, Catherine Hudon, Alain Vanasse, Antoine L Ntetu, Danielle Maltais

Published in: Health and Quality of Life Outcomes | Issue 1/2004

Abstract

Background

Many patients with several concurrent medical conditions (multimorbidity) are seen in the primary care setting. A thorough understanding of outcomes associated with multimorbidity would benefit primary care workers of all disciplines. The purpose of this systematic review was to clarify the relationship between the presence of multimorbidity and the quality of life (QOL) or health-related quality of life (HRQOL) of patients seen, or likely to be seen, in the primary care setting.

Methods

Medline and Embase electronic databases were screened using the following search terms for the reference period 1990 to 2003: multimorbidity, comorbidity, chronic disease, and their spelling variations, along with quality of life and health-related quality of life. Only descriptive studies relevant to primary care were selected.

Results

Of 753 articles screened, 108 were critically assessed for compliance with study inclusion and exclusion criteria. Thirty of these studies were ultimately selected for this review, including 7 in which the relationship between multimorbidity or comorbidity and QOL or HRQOL was the main outcome measure. Major limitations of these studies include the lack of a uniform definition for multimorbidity or comorbidity and the absence of assessment of disease severity. The use of self-reported diagnoses may also be a weakness. The frequent exclusion of psychiatric diagnoses and presence of potential confounding variables are other limitations. Nonetheless, we did find an inverse relationship between the number of medical conditions and QOL related to physical domains. For social and psychological dimensions of QOL, some studies reveal a similar inverse relationship in patients with 4 or more diagnoses.

Conclusions

Our findings confirm the existence of an inverse relationship between multimorbidity or comorbidy and QOL. However, additional studies are needed to clarify this relationship, including the various dimensions of QOL affected. Those studies must employ a clear definition of multimorbidity or comorbidity and valid ways to measure these concepts in a primary care setting. Pursuit of this research will help to better understand the impact of chronic diseases on patients.

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Title: Multimorbidity and quality of life in primary care: a systematic review
Authors: Martin Fortin
Lise Lapointe
Catherine Hudon
Alain Vanasse
Antoine L Ntetu
Danielle Maltais
Publication date: 01-12-2004
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2004
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/1477-7525-2-51

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Multimorbidity and quality of life in primary care: a systematic review

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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