Skip to main content
Top
Gepubliceerd in: Quality of Life Research 3/2016

04-09-2015

Health-related needs of people with multiple chronic diseases: differences and underlying factors

Auteurs: Petra Hopman, François G. Schellevis, Mieke Rijken

Gepubliceerd in: Quality of Life Research | Uitgave 3/2016

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Purpose

To examine the health-related needs of people with multiple chronic diseases in the Netherlands compared to people with one chronic disease, and to identify different subgroups of multimorbid patients based on differences in their health problems.

Methods

Participants were 1092 people with one or more chronic diseases of a nationwide prospective panel study on the consequences of chronic illness in the Netherlands. They completed the EQ-6D, a multi-dimensional questionnaire on health problems (October 2013). Chi-square tests and analyses of variance were performed to test for differences between multimorbid patients and patients with one chronic disease. To identify subgroups of multimorbid patients, cluster analysis was performed and differences in EQ-6D scores between clusters were tested with Chi-square tests.

Results

Multimorbid patients (51 % of the total sample) experience more problems in most health domains than patients with one chronic disease. Almost half (44 %) of the multimorbid people had many health problems in different domains. These people were more often female, had a smaller household size, had a lower health literacy, and suffered from more chronic diseases. Remarkably, a small subgroup of multimorbid patients (4 %, mostly elderly males) is characterized by all having cognitive problems.

Conclusions

Based on the problems they experience, we conclude that patients with multimorbidity have relatively many and diverse health-related needs. Extensive health-related needs among people with multimorbidity may relate not only to the number of chronic diseases they suffer from, but also to their patient characteristics. This should be taken into account, when identifying target groups for comprehensive support programmes.
Voetnoten
1
The distribution of the chronic disease categories is quite similar to that of a large nationwide database containing health data, including the medical diagnoses of chronic diseases, of about 10 % of the Dutch population (NIVEL’s Primary Care Database [17]).
 
2
All diseases (ICPC codes of 70 and higher), except for P codes (psychiatric problems/mental disorders) and Z codes (social problems).
 
Literatuur
1.
go back to reference van Oostrom, S. H., Gijsen, R., Stirbu, I., Korevaar, J. C., Schellevis, F. G., H. S. J. Picavet, & Hoeymans, N. (2014). Rise in the prevalence of chronic diseases and multimorbidity from 2001 to 2011 in the Dutch population, Manuscript submitted for publication. van Oostrom, S. H., Gijsen, R., Stirbu, I., Korevaar, J. C., Schellevis, F. G., H. S. J. Picavet, & Hoeymans, N. (2014). Rise in the prevalence of chronic diseases and multimorbidity from 2001 to 2011 in the Dutch population, Manuscript submitted for publication.
2.
go back to reference Boyd, C., & Fortin, M. (2010). Future of multimorbidity research: How should understanding of multimorbidity inform health system design? Public Health Reviews, 32, 451–474. Boyd, C., & Fortin, M. (2010). Future of multimorbidity research: How should understanding of multimorbidity inform health system design? Public Health Reviews, 32, 451–474.
4.
go back to reference Bower, P., Macdonald, W., Harkness, E., Gask, L., Kendrick, T., Valderas, J. M., et al. (2011). Multimorbidity, service organization and clinical decision making in primary care: A qualitative study. Family Practice, 28(5), 579–587. doi:10.1093/fampra/cmr018.CrossRefPubMed Bower, P., Macdonald, W., Harkness, E., Gask, L., Kendrick, T., Valderas, J. M., et al. (2011). Multimorbidity, service organization and clinical decision making in primary care: A qualitative study. Family Practice, 28(5), 579–587. doi:10.​1093/​fampra/​cmr018.CrossRefPubMed
5.
go back to reference Smith, S. M., Soubhi, H., Fortin, M., Hudon, C., & O’Dowd, T. (2012). Managing patients with multimorbidity: Systematic review of interventions in primary care and community settings. Cochrane Database of Systematic Reviews,. doi:10.1002/14651858.CD006560.pub2. Smith, S. M., Soubhi, H., Fortin, M., Hudon, C., & O’Dowd, T. (2012). Managing patients with multimorbidity: Systematic review of interventions in primary care and community settings. Cochrane Database of Systematic Reviews,. doi:10.​1002/​14651858.​CD006560.​pub2.
7.
go back to reference Vogeli, C., Shields, A. E., Lee, T. A., Gibson, T. B., Marder, W. D., Weiss, K. B., et al. (2007). Multiple chronic conditions: Prevalence, health consequences, and implications for quality, care management, and costs. Journal of General Internal Medicine, 22(Suppl. 3), 391–395. doi:10.1007/s11606-007-0322-1.PubMedCentralCrossRefPubMed Vogeli, C., Shields, A. E., Lee, T. A., Gibson, T. B., Marder, W. D., Weiss, K. B., et al. (2007). Multiple chronic conditions: Prevalence, health consequences, and implications for quality, care management, and costs. Journal of General Internal Medicine, 22(Suppl. 3), 391–395. doi:10.​1007/​s11606-007-0322-1.PubMedCentralCrossRefPubMed
8.
go back to reference Fortin, M., Bravo, G., Hudon, C., Lapointe, L., Almirall, J., Dubois, M. F., et al. (2006). Relationship between multimorbidity and health-related quality of life of patients in primary care. Quality of Life Research, 15, 83–91.CrossRefPubMed Fortin, M., Bravo, G., Hudon, C., Lapointe, L., Almirall, J., Dubois, M. F., et al. (2006). Relationship between multimorbidity and health-related quality of life of patients in primary care. Quality of Life Research, 15, 83–91.CrossRefPubMed
9.
go back to reference Sprangers, M. A., de Regt, E. B., Andries, F., van Agt, H. M., Bijl, R. V., de Boer, J. B., et al. (2000). Which chronic conditions are associated with better or poorer quality of life? Journal of Clinical Epidemiology, 53(9), 895–907.CrossRefPubMed Sprangers, M. A., de Regt, E. B., Andries, F., van Agt, H. M., Bijl, R. V., de Boer, J. B., et al. (2000). Which chronic conditions are associated with better or poorer quality of life? Journal of Clinical Epidemiology, 53(9), 895–907.CrossRefPubMed
10.
11.
go back to reference Rijken, M., Struckmann, V., Dyakova, M., Melchiorre, M. G., Rissanen, S., & van Ginneken, E. (2013). ICARE4EU: Improving care for people with multiple chronic conditions in Europe. Eurohealth, 19(3), 29–31. Rijken, M., Struckmann, V., Dyakova, M., Melchiorre, M. G., Rissanen, S., & van Ginneken, E. (2013). ICARE4EU: Improving care for people with multiple chronic conditions in Europe. Eurohealth, 19(3), 29–31.
13.
go back to reference de Bruin, S. R., Heijink, R., Lemmens, L., Struijs, J. N., & Baan, C. A. (2011). Impact of disease management programs on health-care expenditures for patients with diabetes, depression, heart failure or chronic obstructive pulmonary disease: A systematic review of the literature. Health Policy, 101, 105–121. doi:10.1016/j.healthpol.2011.03.006.CrossRefPubMed de Bruin, S. R., Heijink, R., Lemmens, L., Struijs, J. N., & Baan, C. A. (2011). Impact of disease management programs on health-care expenditures for patients with diabetes, depression, heart failure or chronic obstructive pulmonary disease: A systematic review of the literature. Health Policy, 101, 105–121. doi:10.​1016/​j.​healthpol.​2011.​03.​006.CrossRefPubMed
14.
go back to reference Boult, C., Green, A. F., Boult, L. B., Pacala, J. T., Snyder, C., & Leff, B. (2009). Successful models of comprehensive care for older adults with chronic conditions: Evidence for the institute of medicine’s “retooling for an Aging America” report. Journal of the American Geriatrics Society, 57, 2328–2337. doi:10.1111/j.1532-5415.2009.02571.x.CrossRefPubMed Boult, C., Green, A. F., Boult, L. B., Pacala, J. T., Snyder, C., & Leff, B. (2009). Successful models of comprehensive care for older adults with chronic conditions: Evidence for the institute of medicine’s “retooling for an Aging America” report. Journal of the American Geriatrics Society, 57, 2328–2337. doi:10.​1111/​j.​1532-5415.​2009.​02571.​x.CrossRefPubMed
15.
go back to reference Baanders, A. N., Rijken, P. M., & Peters, L. (2002). Labour participation of the chronically ill: A profile sketch. European Journal of Public Health, 12(2), 124–130.CrossRefPubMed Baanders, A. N., Rijken, P. M., & Peters, L. (2002). Labour participation of the chronically ill: A profile sketch. European Journal of Public Health, 12(2), 124–130.CrossRefPubMed
16.
go back to reference Hingstman, L., & Kenens, R. J. (2009). Cijfers uit de registratie van huisartsen: Peiling 2009. Utrecht: NIVEL. Hingstman, L., & Kenens, R. J. (2009). Cijfers uit de registratie van huisartsen: Peiling 2009. Utrecht: NIVEL.
18.
go back to reference Krabbe, P. F. M., Stouthard, M. E. A., Essink-Bot, M. L., & Bonsel, G. J. (1999). The effect of adding a cognitive dimension to the EuroQol multiattribute health-status classification system. Journal of Clinical Epidemiology, 52, 293–301. doi:10.1016/S0895-4356(98)00163-2.CrossRefPubMed Krabbe, P. F. M., Stouthard, M. E. A., Essink-Bot, M. L., & Bonsel, G. J. (1999). The effect of adding a cognitive dimension to the EuroQol multiattribute health-status classification system. Journal of Clinical Epidemiology, 52, 293–301. doi:10.​1016/​S0895-4356(98)00163-2.CrossRefPubMed
22.
go back to reference van Tilburg, T. G., & de Leeuw, E. D. (1991). Stability of scale quality under various data collection procedures: A mode comparison of the “De Jong-Gierveld Loneliness Scale.”. International Journal of Public Opinion Research, 3, 69–85. doi:10.1093/ijpor/3.1.69.CrossRef van Tilburg, T. G., & de Leeuw, E. D. (1991). Stability of scale quality under various data collection procedures: A mode comparison of the “De Jong-Gierveld Loneliness Scale.”. International Journal of Public Opinion Research, 3, 69–85. doi:10.​1093/​ijpor/​3.​1.​69.CrossRef
23.
go back to reference van Knippenberg, F. C., & de Haes, J. C. (1988). Measuring the quality of life of cancer patients: Psychometric properties of instruments. Journal of Clinical Epidemiology, 41(11), 1043–1053.CrossRefPubMed van Knippenberg, F. C., & de Haes, J. C. (1988). Measuring the quality of life of cancer patients: Psychometric properties of instruments. Journal of Clinical Epidemiology, 41(11), 1043–1053.CrossRefPubMed
24.
25.
go back to reference Lamberts, H., & Wood, M. (1987). International classification of primary care. Oxford: Oxford University Press. Lamberts, H., & Wood, M. (1987). International classification of primary care. Oxford: Oxford University Press.
26.
go back to reference Nationale Raad voor de Volksgezondheid. Standaardisatie van chroniciteitsbegrippen. Vooronderzoek naar het definiëren en specificeren van chroniciteit van gezondheidsproblemen ten behoeve van classificaties. Zoetermeer, The Netherlands: Nationale Raad voor de Volksgezondheid, 1995. Nationale Raad voor de Volksgezondheid. Standaardisatie van chroniciteitsbegrippen. Vooronderzoek naar het definiëren en specificeren van chroniciteit van gezondheidsproblemen ten behoeve van classificaties. Zoetermeer, The Netherlands: Nationale Raad voor de Volksgezondheid, 1995.
28.
go back to reference Fortin, M., Bravo, G., Hudon, C., Lapointe, L., Dubois, M. F., & Almirall, J. (2006). Psychological distress and multimorbidity in primary care. Annals of Family Medicine, 4, 417–422.PubMedCentralCrossRefPubMed Fortin, M., Bravo, G., Hudon, C., Lapointe, L., Dubois, M. F., & Almirall, J. (2006). Psychological distress and multimorbidity in primary care. Annals of Family Medicine, 4, 417–422.PubMedCentralCrossRefPubMed
29.
go back to reference Thoits, P. A. (1986). Social support as coping assistance. Journal of Consulting and Clinical Psychology, 54(4), 416–423.CrossRefPubMed Thoits, P. A. (1986). Social support as coping assistance. Journal of Consulting and Clinical Psychology, 54(4), 416–423.CrossRefPubMed
Metagegevens
Titel
Health-related needs of people with multiple chronic diseases: differences and underlying factors
Auteurs
Petra Hopman
François G. Schellevis
Mieke Rijken
Publicatiedatum
04-09-2015
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 3/2016
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-015-1102-8

Andere artikelen Uitgave 3/2016

Quality of Life Research 3/2016 Naar de uitgave