Multimorbidity and quality of life in primary care: a systematic review
Open accessAbstract
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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Results are similar to previous meta-analyses and reviews, pointing towards conclusive evidence that additional factors (physical or psychological) decrease QoL and functionality in asthma.
“Results are similar to previous meta-analyses and reviews,8,72 pointing towards conclusive evidence that additional factors (physical or psychological) decrease QoL and functionality in asthma.”
From A systematic review of psychological, physical health factors, and quality of life in adult asthma (2019) · cites this paper as [72]
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- Authors
- Fortin, M., Lapointe, L., Hudon, C., Vanasse, A., Ntetu, A. L., & Maltais, D.
- Affiliations
- Université de Sherbrooke (CA)
- Université du Québec à Chicoutimi (CA)
- Corresponding author
- Fortin, Martin
- Venue
- Health and Quality of Life Outcomes
- Published
- 2004-09-20
- Volume
- 2
- Issue
- 1
- Pages
- 51-51
- ISSN
- 1477-7525 (ISSN-L)
- PMC
- PMC526383
- OpenAlex
- W2117059102
- Cited by
- 963
- References
- 70
- Citations by year
- 2026: 37 · 2025: 68 · 2024: 67 · 2023: 58 · 2022: 82 · 2021: 77 · 2020: 72 · 2019: 78 · 2018: 55 · 2017: 59 · 2016: 54 · 2015: 41 · 2014: 35 · 2013: 36 · 2012: 36
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Health and Quality of Life Outcomes (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Constellation (Université du Québec à Chicoutimi) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Pfizer
- Université de Sherbrooke
- Pfizer Canada
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- multimorbidity, comorbidities, health-related quality of life, quality of life, primary care, chronic disease, physical health, psychosocial well-being, number of diagnoses
- MeSH terms
- Chronic Disease, Health Services Research, Health Status Indicators, Humans, Primary Health Care, Quality of Life, Comorbidity, Databases, Bibliographic, Outcome Assessment, Health Care
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