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Influence of chronic diseases on long-term change in physical health: a consultation–survey linkage cohort study in general practice

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Abstract

Purpose

To investigate the influence of disease severity within cardiovascular disease (CVD) and musculoskeletal (MSK) disorder spectrums on physical health change over 3 years.

Methods

Consultation records of 4,672 patients aged 50 years and above from six general practices were linked to their baseline and 3-year Short-Form-12 (SF-12) physical component summary (PCS) scores. Associations between exclusive diagnostic categories and comorbid counts with physical health change over 3 years were examined.

Results

There were 1,371 (29.3%) CVD and 1,972 (42.2%) MSK consulters. Adjusted additional change in PCS scores relative to hypertension ranged from −0.43 (95% confidence interval −2.5, 1.7) for atrial fibrillation to −2.09 (−4.2, 0.0) for heart failure. In the MSK spectrum, changes relative to soft tissue disorder ranged from −0.63 (−3.0, 1.8) for soft tissue pain to −1.09 (−4.1, 2.0) for inflammatory polyarthropathy. A trend in association between increasing disease severity and deterioration in physical health was only observed within the CVD spectrum, and this trend was retained in those with CVD and higher levels of comorbidity.

Conclusions

CVD severity with higher levels of comorbidity was associated with greater relative deterioration in long-term physical health. Such findings were not found for the MSK cohorts, suggesting the differing health impact of different chronic diseases.

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Abbreviations

CVD:

Cardiovascular disease

IMD:

Index of Multiple Deprivation

MCS:

Mental component summary score

MSK:

Musculoskeletal

OA:

Osteoarthritis

PCS:

Physical component summary score

RA:

Rheumatoid arthritis

SF-12:

Short-Form-12 health survey

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Acknowledgments

We would like to thank the patients who took part in the survey and gave consent and teams from the Arthritis Research UK Primary Care Centre who conducted the study. UTK was funded by a NIHR Fellowship; project funding was by the Medical Research Council (UK) and the North Staffordshire Primary Care R&D Consortium.

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Authors and Affiliations

  1. Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, ST5 5BG, UK

    J. A. Prior, K. P. Jordan & U. T. Kadam

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  1. J. A. Prior
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Correspondence to J. A. Prior.

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Prior, J.A., Jordan, K.P. & Kadam, U.T. Influence of chronic diseases on long-term change in physical health: a consultation–survey linkage cohort study in general practice. Qual Life Res 21, 581–591 (2012). https://doi.org/10.1007/s11136-011-9974-8

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