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Association between Multimorbidity and Quality of Life among Adults Attending Outpatient Clinics in the Ashanti Region: A Cross-Sectional Study

DOI: 10.4236/oalib.1111604, PP. 1-13

Subject Areas: Women’s Health, Emergency & Critical Care, Epidemiology, Internal Medicine, Global Health, Public Health, Health Policy

Keywords: Multimorbidity, Quality of Life, Outpatient Clinics, Ashanti Region, Ghana, SF-36, Cross-Sectional Study

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Abstract

Multimorbidity, the coexistence of two or more chronic conditions in an individual, is increasingly prevalent worldwide, posing significant challenges for healthcare systems and patient well-being. This cross-sectional study aims to investigate the association between multimorbidity and quality of life (QoL) among adults attending outpatient clinics in health facilities within the Ashanti Region of Ghana. Method: A sample of n = 400 participants were recruited using convenience sampling. Data were collected through structured interviews using the Short Form Health Survey (SF-36) to assess QoL and a checklist to ascertain multimorbidity status. Statistical analyses including correlation and regression analyses were performed to explore the relationship between multimorbidity and QoL, adjusting for potential variables. Results: The findings reveal that there is no statistically significant association between multi-morbidity and the perceived changes in current health compared to one year ago (X2 = 4.814, p = 0.307), with 11.76% of those with multi-morbidity reporting better health, and 11.14% of non-multi-morbid individuals reporting the same. Similarly, role function, general health, and energy and fatigue did not demonstrate statistically significant associations with multi-morbidity. However, the emotional problem variable approached significance (X2 = 9.299, p = 0.054*), with 35.29% of individuals with multi-morbidity experiencing emotional issues compared to 25.90% among non-multi-morbid individuals. Notably, health change exhibited a significant association (X2 = 4.812, p = 0.028), indicating that 73.53% of those with multi-morbidity reported a worsening health change, compared to 59.34% of non-multi-morbid individuals. Conclusion: This study sheds light on the nuanced relationship between multi-morbidity and various dimensions of perceived health. While no significant associations were found between multi-morbidity and certain aspects such as role function, general health perception, and energy/fatigue levels, notable findings emerged regarding emotional well-being and health changes over time.

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Acquaye, J. , Brenyah, J. K. , Brobbey-Kyei, I. A. and Brobbey-Kyei, E. (2024). Association between Multimorbidity and Quality of Life among Adults Attending Outpatient Clinics in the Ashanti Region: A Cross-Sectional Study. Open Access Library Journal, 11, e1604. doi: http://dx.doi.org/10.4236/oalib.1111604.

References

[1]  WHO (2016) World Health Statistics 2016: Monitoring Health for the SDGs, Sustainable Development Goals.
[2]  Mercer, S., Salisbury, C. and Fortin, M. (2014) ABC of Multimorbidity. John Wiley & Sons, Ltd., London.
[3]  Ho, I.S.-S., Azcoaga-Lorenzo, A., Akbari, A., Black, C., Davies, J., Hodgins, P., et al. (2021) Examining Variation in the Measurement of Multimorbidity in Research: A Systematic Review of 566 Studies. The Lancet Public Health, 6, E587-E597.
https://doi.org/10.1016/S2468-2667(21)00107-9
[4]  Xu, X., Mishra, G.D. and Jones, M. (2017) Mapping the Global Research Landscape and Knowledge Gaps on Multimorbidity: A Bibliometric Study. Journal of Global Health, 7, Article 010414. https://www.icmje.org/disclosure-of-interest/
https://doi.org/10.7189/jogh.07.010414
[5]  Zemedikun, D.T., Gray, L.J., Khunti, K., Davies, M.J. and Dhalwani, N.N. (2018) Patterns of Multimorbidity in Middle-Aged and Older Adults: An Analysis of the UK Biobank Data. Mayo Clinic Proceedings, 93, 857-866.
https://doi.org/10.1016/j.mayocp.2018.02.012
[6]  Abebe, F., Schneider, M., Asrat, B. and Ambaw, F. (2020) Multimorbidity of Chronic Non-Communicable Diseases in Low- and Middle-Income Countries: A Scoping Review. Journal of Comorbidity, 10, 1-13.
https://doi.org/10.1177/2235042X20961919
[7]  Asogwa, O.A., Boateng, D., Marzà-Florensa, A., Peters, S., Levitt, N., van Olmen, J., et al. (2022) Multimorbidity of Non-Communicable Diseases in Low-Income and Middleincome Countries: A Systematic Review and Meta-Analysis. BMJ Open, 12, e049133. https://doi.org/10.1136/bmjopen-2021-049133
[8]  Bhagavathula, A.S., Gebreyohannes, E.A., Seid, M.A., Adane, A., Brkic, J. and Fialová, D. (2021) Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia. Pharmaceuticals, 14, Article 844.
https://doi.org/10.3390/ph14090844
[9]  Eyowas, F.A., Schneider, M., Alemu, S., Pati, S. and Getahun, F.A. (2022) Magnitude, Pattern and Correlates of Multimorbidity among Patients Attending Chronic Outpatient Medical Care in Bahir Dar, Northwest Ethiopia: The Application of Latent Class Analysis Model. PLOS ONE, 17, e0267208.
https://doi.org/10.1371/journal.pone.0267208
[10]  Calderon-Larranaga, A., Vetrano, D.L., Ferrucci, L., Mercer, S.W., Marengoni, A., Onder, G., et al. (2018) Multimorbidity and Functional Impairment: Bidirectional Interplay, Synergistic Effects and Common Pathways. Journal of Internal Medicine, 285, 255-271. https://doi.org/10.1111/joim.12843
[11]  Kingston, A., Robinson, L., Booth, H., Knapp, M. and Jagger, C. (2018) Projections of Multi-Morbidity in the Older Population in England to 2035: Estimates from the Population Ageing and Care Simulation (PACSim) Model. Age and Ageing, 47, 374-380. https://doi.org/10.1093/ageing/afx201
[12]  Mounce, L.T.A., Campbell, J.L., Henley, W.E., Tejerina Arreal, M.C., Porter, I. and Valderas, J.M. (2018) Predicting Incident Multimorbidity. Annals of Family Medicine, 16, 322-329. https://doi.org/10.1370/afm.2271
[13]  Ornstein, S.M., Nietert, P.J., Jenkins, R.G. and Litvin, C.B. (2013) The Prevalence of Chronic Diseases and Multimorbidity in Primary Care Practice: A PPRNet Report. Journal of the American Board of Family Medicine, 26, 518-524.
https://doi.org/10.3122/jabfm.2013.05.130012
[14]  Willadsen, T., Jarbøl, D., Reventlow, S., Mercer, S., et al. (2018) Multimorbidity and Mortality: A 15-Year Longitudinal Registry-Based Nationwide Danish Population Study. Journal of Comorbidity, 8, 1-9. https://doi.org/10.1177/2235042X18804063
[15]  Barnett, K., Mercer, S.W., Norbury, M., Watt, G., Wyke, S. and Guthrie, B. (2012) Epidemiology of Multimorbidity and Implications for Health Care, Research, and Medical Education: A Cross-Sectional Study. The Lancet, 380, 37-43.
https://doi.org/10.1016/S0140-6736(12)60240-2
[16]  Romano, E., Ma, R., Vancampfort, D., Firth, J., Felez-Nobrega, M., Haro, J.M., et al. (2021) Multimorbidity and Obesity in Older Adults from Six Low- and Middle-Income Countries. Preventive Medicine, 153, Article 106816.
https://doi.org/10.1016/j.ypmed.2021.106816
[17]  Violan, C., Foguet-Boreu, Q., Flores-Mateo, G., Salisbury, C., Blom, J., Freitag, M., et al. (2014) Prevalence, Determinants and Patterns of Multimorbidity in Primary Care: A Systematic Review of Observational Studies. PLOS ONE, 9, e102149.
https://doi.org/10.1371/journal.pone.0102149
[18]  Alimohammadian, M., Majidi, A., Yaseri, M., Ahmadi, B., Islami, F., Derakhshan, M., et al. (2017) Multimorbidity as an Important Issue among Women: Results of a Gender Difference Investigation in a Large Population-Based Cross-Sectional Study in West Asia. BMJ Open, 7, e013548. https://doi.org/10.1136/bmjopen-2016-013548
[19]  Skou, S.T., Mair, F.S., Fortin, M., Guthrie, B., Nunes, B.P., Miranda, J.J., et al. (2022) Multimorbidity. Nature Reviews Disease Primers, 8, Article No. 48.
https://doi.org/10.1038/s41572-022-00376-4
[20]  AMS (2018) Multimorbidity: A Priority for Global Health Research.
[21]  Freisling, H., Viallon, V., Lennon, H., Bagnardi, V., Ricci, C., Butterworth, A.S., et al. (2020) Lifestyle Factors and Risk of Multimorbidityof Cancer and Cardiometabolic Diseases: Amultinational Cohort Study. BMC Medicine, 18, Article No. 5.
https://doi.org/10.1186/s12916-019-1474-7
[22]  van den Akker, M., Buntinx, F., Metsemakers, J.F.M., Roos, S. and Knottnerus, J.A. (1998) Multimorbidity in General Practice: Prevalence, Incidence, and Determinants of Co-Occurring Chronic and Recurrent Diseases. Journal of Clinical Epidemiology, 51, 367-375. https://doi.org/10.1016/S0895-4356(97)00306-5
[23]  France, E.F., Wyke, S., Gunn, J.M., Mair, F.S., McLean, G. and Mercer, S.W. (2012) Multimorbidity in Primary Care: A Systematic Review of Prospective Cohort Studies. The British Journal of General Practice, 62, e297-e307.
https://doi.org/10.3399/bjgp12X636146
[24]  Marengoni, A., Angleman, S., Melis, R., Mangialasche, F., Karp, A., Garmen, A., et al. (2011) Aging with Multimorbidity: A Systematic Review of the Literature. Ageing Research Reviews, 10, 430-439. https://doi.org/10.1016/j.arr.2011.03.003
[25]  Aiden, H. (2018) Multimorbidity: Understanding the Challenge. Report, the Richmond Group of Charities.
[26]  Harrison, C., Henderson, J., Miller, G. and Britt, H. (2017) The Prevalence of Diagnosed Chronic Conditions and Multimorbidity in Australia: A Method for Estimating Population Prevalence from General Practice Patient Encounter Data. PLOS ONE, 12, e0172935. https://doi.org/10.1371/journal.pone.0172935
[27]  Hunter, M.L., Knuiman, M.W., Musk, B.A.W., Hui, J., Murray, K., Beilby, J.P., et al. (2021) Prevalence and Patterns of Multimorbidity in Australian Baby Boomers: The Busselton Healthy Ageing Study. BMC Public Health, 21, Article No. 1539.
https://doi.org/10.1186/s12889-021-11578-y
[28]  Hunger, M., Thorand, B., Schunk, M., Doring, A., Menn, P., Peters, A., et al. (2011) Multimorbidity and Health-Related Quality of Life in the Older Population: Results from the German KORA-Age Study. Health and Quality of Life Outcomes, 9, Article No. 53. https://doi.org/10.1186/1477-7525-9-53
[29]  NICE (2016) Multimorbidity: Clinical Assessment and Management: Multimorbidity: Assessment, Prioritisation and Management of Care for People with Commonly Occurring Multimorbidity. NICE Guideline NG56, National Institute for Health and Care Excellence.
[30]  Leijten, F.R.M., Struckmann, V., van Ginneken, E., Czypionka, T., Kraus, M., Reiss, M., et al. (2018) The SELFIE Framework for Integrated Care for Multi-Morbidity: Development and Description. Health Policy, 122, 12-22.
https://doi.org/10.1016/j.healthpol.2017.06.002
[31]  Riley, E. (2018) Just One Thing after Another’ Living with Multiple Conditions. Report, Taskforce on Multiple Conditions.
[32]  Bayliss, E.A., Bonds, D.E., Boyd, C.M., Davis, M.M., Finke, B., Fox, M.H., et al. (2014) Understanding the Context of Health for Persons with Multiple Chronic Conditions: Moving from What Is the Matter to What Matters. The Annals of Family Medicine, 12, 260-269. https://doi.org/10.1370/afm.1643
[33]  Guthrie, B., Payne, K., Alderson, P., McMurdo, M.E.T. and Mercer, S.W. (2012) Adapting Clinical Guidelines to Take Account of Multimorbidity. BMJ, 345, e6341.
https://doi.org/10.1136/bmj.e6341
[34]  Young, C.E., Boyle, F.M. and Mutch, A.J. (2016) Are Care Plans Suitable for the Management of Multiple Conditions? Journal of Comorbidity, 6, 103-113.
https://doi.org/10.15256/joc.2016.6.79
[35]  Salisbury, C., Man, M.S., Bower, P., Guthrie, B., Chaplin, K., Gaunt, D.M., et al. (2018) Management of Multimorbidity Using a Patient-Centred Care Model: A Pragmatic Cluster-Randomised Trial of the 3D Approach. The Lancet, 392, 41-50.
https://doi.org/10.1016/S0140-6736(18)31308-4
[36]  Ailabouni, N.J., Hilmer, S.N., Kalisch, L., Braund, R. and Reeve, E. (2020) COVID-19 Pandemic: Considerations for Safe Medication Use in Older Adults with Multimorbidity and Polypharmacy. Journals of Gerontology Series A, 76, 1068-1073.
https://doi.org/10.1093/gerona/glaa104
[37]  Guan, W.-J., Liang, W.-H., Zhao, Y., Liang, H.-R., Chen, Z.-S., Li, Y.-M., et al. (2020) Cardiovascular Comorbidity and Its Impact on Patients with COVID-19. European Respiratory Journal, 55, Article 2001227.
https://doi.org/10.1183/13993003.01227-2020
[38]  Fortin, M., Dubois, M.F., Hudon, C., Soubhi, H. and Almirall, J. (2007) Multimorbidity and Quality of Life: A Closer Look. Health and Quality of Life Outcomes, 5, Article No. 52. https://doi.org/10.1186/1477-7525-5-52
[39]  Fortin, M., Lapointe, L., Hudon, C., Vanasse, A., Ntetu, A.L. and Maltais, D. (2004) Multimorbidity and Quality of Life in Primary Care: A Systematic Review. Health and Quality of Life Outcomes, 2, Article No. 51.
https://doi.org/10.1186/1477-7525-2-51
[40]  Makovski, T.T., Schmitz, S., Zeegers, M.P., Stranges, S. and van den Akker, M. (2019) Multimorbidity and Quality of Life: Systematic Literature Review and Meta-Analysis. Ageing Research Reviews, 53, Article 100903.
https://doi.org/10.1016/j.arr.2019.04.005
[41]  Hagell, P., Westergren, A. and Årestedt, K. (2017) Beware of the Origin of Numbers: Standard Scoring of the SF-12 and SF-36 Summary Measures Distorts Measurement and Score Interpretations. Research in Nursing & Health, 40, 378-386.
https://doi.org/10.1002/nur.21806
[42]  Lall, R., Campbell, M.J., Walters, S.J. and Morgan, K. (2002) A Review of Ordinal Regression Models Applied on Health-Related Quality of Life Assessments. Statistical Methods in Medical Research, 11, 49-67.
https://doi.org/10.1191/0962280202sm271ra
[43]  Williams, R. (2016) Understanding and Interpreting Generalized Ordered Logit Models. The Journal of Mathematical Sociology, 40, 7-20.
https://doi.org/10.1080/0022250X.2015.1112384
[44]  Peterson, B., Frank, E. and Harrell, J. (1990) Partial Proportional Odds Models for Ordinal Response Variables. Journal of the Royal Statistical Society Series C, 39, 205-217. https://doi.org/10.2307/2347760
[45]  Abreu, M.N.S., Siqueira, A.L., Cardoso, C.S. and Caiaffa, W.T. (2008) Ordinal Logistic Regression Models: Application in Quality of Life Studies. Cadernos de Saúde Pública, 24, S581-S591. https://doi.org/10.1590/S0102-311X2008001600010
[46]  Austad, B., Hetlevik, I., Mjolstad, B.P. and Helvik, A.S. (2016) Applying Clinical Guidelines in General Practice: A Qualitative Study of Potential Complications. BMC Family Practice, 17, Article No. 92.
https://doi.org/10.1186/s12875-016-0490-3
[47]  Turner, A., Mulla, A., Booth, A., Aldridge, S., Stevens, S., Begum, M., et al. (2018) The International Knowledge Base for New Care Models Relevant to Primary Care-Led Integrated Models: A Realist Synthesis. Health Services and Delivery Research, 6. https://doi.org/10.3310/hsdr06250
[48]  Ware, J.E., Kosinski, M. and Keller, S.D. (1996) A 12-Item Short-Form Health Survey. Medical Care, 34, 220-233.
https://doi.org/10.1097/00005650-199603000-00003
[49]  The SF-36v2® Health Survey. Quality Metric.
https://www.qualitymetric.com/health-surveys/the-sf-36v2-health-survey/
[50]  National Center for Interprofessional Practice and Education (2016) The Short-Form (SF-36) Health Survey.
https://nexusipe.org/advancing/assessment-evaluation/short-form-sf-36-health-survey
[51]  FORWARD (2021) What Are the SF-36, PCS, and MCS?
https://www.forwarddatabank.org/knowledge-base/what-are-the-sf-36-pcs-and-mcs/

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