Which chronic conditions are associated with better or poorer quality of life?

Sprangers, Mirjam A.G.; de Regt, Ellen B.; Andries, Frank; van Agt, Heleen M.E.; Bijl, Rob V.; de Boer, Josien B.; Foets, Marleen; Hoeymans, Nancy; Jacobs, Annelies E.; Kempen, Gertrudis I.J.M.; Miedema, Harold S.; Tijhuis, Marja A.R.; de Haes, Hanneke C.J.M.

« Previous Next »Journal of Clinical Epidemiology
Volume 53, Issue 9 , Pages 895-907, September 2000

Which chronic conditions are associated with better or poorer quality of life?

Mirjam A.G. Sprangers
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
- Corresponding author. Tel: 31-20-566-4661; fax: 31-20-566-9104.(M.A.G. Sprangers)
Ellen B. de Regt
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands
Frank Andries
- NIA TNO, Leiden, The Netherlands
Heleen M.E. van Agt
- Instituut Maatschappelijke Gezondheidszorg, Erasmus University, Rotterdam, The Netherlands
Rob V. Bijl
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
Josien B. de Boer
- Department of Medical Psychology and Psychotherapy, Erasmus University, Rotterdam, The Netherlands
Marleen Foets
- Netherlands Institute of Primary Health Care (NIVEL), Utrecht, The Netherlands
Nancy Hoeymans
- National Institute of Public Health and the Environment, Bilthoven, The Netherlands
Annelies E. Jacobs
- Centre for Quality of Care Research (WOK), University of Nijmegen, Nijmegen, The Netherlands
Gertrudis I.J.M. Kempen
- Northern Center for Healthcare Research, Groningen and Department of Medical Sociology, Maastricht University, Maastricht, The Netherlands
Harold S. Miedema
- TNO Prevention and Health, Leiden, The Netherlands
Marja A.R. Tijhuis
- National Institute of Public Health and the Environment, Bilthoven, The Netherlands
Hanneke C.J.M. de Haes
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands

Received 4 May 1999; received in revised form 4 January 2000; accepted 21 January 2000.

Abstract

The objective of the present study is to compare the QL of a wide range of chronic disease patients. Secondary analysis of eight existing data sets, including over 15,000 patients, was performed. The studies were conducted between 1993 and 1996 and included population-based samples, referred samples, consecutive samples, and/or consecutive samples. The SF-36 or SF-24 were employed as generic QL instruments. Patients who were older, female, had a low level of education, were not living with a partner, and had at least one comorbid condition, in general, reported the poorest level of QL. On the basis of rank ordering across the QL dimensions, three broad categories could be distinguished. Urogenital conditions, hearing impairments, psychiatric disorders, and dermatologic conditions were found to result in relatively favorable functioning. A group of disease clusters assuming an intermediate position encompassed cardiovascular conditions, cancer, endocrinologic conditions, visual impairments, and chronic respiratory diseases. Gastrointestinal conditions, cerebrovascular/neurologic conditions, renal diseases, and musculoskeletal conditions led to the most adverse sequelae. This categorization reflects the combined result of the diseases and comorbid conditions. If these results are replicated and validated in future studies, they can be considered in addition to information on the prevalence of the diseases, potential benefits of care, and current disease-specific expenditures. This combined information will help to better plan and allocate resources for research, training, and health care.

Keywords: Quality of life, Health status, Functioning, Chronic disease, Comparison