Author:
Fortin Martin,Hudon Catherine,Dubois Marie-France,Almirall José,Lapointe Lise,Soubhi Hassan
Abstract
Abstract
Background
Measures of multimorbidity are often applied to source data, populations or outcomes outside the scope of their original developmental work. As the development of a multimorbidity measure is influenced by the population and outcome used, these influences should be taken into account when selecting a multimorbidity index. The aim of this study was to compare the strength of the association of health-related quality of life (HRQOL) with three multimorbidity indices: the Cumulative Illness Rating Scale (CIRS), the Charlson index (Charlson) and the Functional Comorbidity Index (FCI). The first two indices were not developed in light of HRQOL.
Methods
We used data on chronic diseases and on the SF-36 questionnaire assessing HRQOL of 238 adult primary care patients who participated in a previous study. We extracted all the diagnoses for every patient from chart review to score the CIRS, the FCI and the Charlson. Data for potential confounders (age, sex, self-perceived economic status and self-perceived social support) were also collected. We calculated the Pearson correlation coefficients (r) of the SF-36 scores with the three measures of multimorbidity, as well as the coefficient of determination, R2, while controlling for confounders.
Results
The r values for the CIRS (range: -0.55 to -0.18) were always higher than those for the FCI (-0.47 to -0.10) and Charlson (-0.31 to -0.04) indices. The CIRS explained the highest percent of variation in all scores of the SF-36, except for the Mental Component Summary Score where the variation was not significant. Variations explained by the FCI were significant in all scores of SF-36 measuring physical health and in two scales evaluating mental health. Variations explained by the Charlson were significant in only three scores measuring physical health.
Conclusion
The CIRS is a better choice as a measure of multimorbidity than the FCI and the Charlson when HRQOL is the outcome of interest. However, the FCI may provide a good option to evaluate the physical aspect of HRQOL for the ease in its administration and scoring. The Charlson index may not be recommended as a measure of multimorbidity in studies related to either physical or mental aspects of HRQOL.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,General Medicine
Reference25 articles.
1. Harboun M, Ankri J: [Comorbidity indexes: review of the literature and application to studies of elderly population][French]. Rev Epidemiol Sante Publique 2001, 49: 287–298.
2. de Groot V, Beckerman H, Lankhorst GJ, Bouter LM: How to measure comorbidity. a critical review of available methods. J Clin Epidemiol 2003, 56: 221–229. 10.1016/S0895-4356(02)00585-1
3. Cheng L, Cumber S, Dumas C, Winter R, Nguyen KM, Nieman LZ: Health related quality of life in pregeriatric patients with chronic diseases at urban, public supported clinics. Health and Quality of Life Outcomes 2003,1(1):63. 10.1186/1477-7525-1-63
4. Wensing M, Vingerhoets E, Grol R: Functional status, health problems, age and comorbidity in primary care patients. Qual Life Res 2001, 10: 141–148. 10.1023/A:1016705615207
5. Michelson H, Bolund C, Brandberg Y: Multiple chronic health problems are negatively asociated with health related quality of life (HRQoL) irrespective of age. Qual Life Res 2000, 9: 1093–1104. 10.1023/A:1016654621784
Cited by
141 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献