The impact of chronic diseases on the health-related quality of life (HRQOL) of Chinese patients in primary care

Background. Ageing of the population results in an increasing number of peo ple living with chronic diseases that can adversely affect their quality of life. Information on the impact of chronic diseases on quality of life can make health services more patient-centred. Objectives. The aim of this study was to determine the impact of eight chro nic diseases on the health-related quality of life (HRQOL) of Chinese patie nts. Methods. A cross-sectional case-control study was carried out on 760 adult Chinese patients of a family medicine clinic in Hong Kong. Each subject ans wered the COOP/WONCA charts and a standard questionnaire on demographic and morbidity data. The likelihood of sub-optimal COOP/WONCA scores of each di sease group was compared with that of patients without any of the surveyed diseases. The independent effects of each disease on the COOP/WONCA scores were analysed by multivariate logistic regression, controlling for demograp hic variables and comorbidity. Results. Depression increased the risks for sub-optimal scores in all but o ne COOP/WONCA chart with odds ratios (OR) ranging from 2.1818 to 3.8645. Hy pertension increased the risk of a sub-optimal physical fitness score (OR 1 .7263). Increased risk of limitations in daily activities was associated wi th stroke (OR = 1.8771), osteoarthritis of the knee (OR = 1.5867), diseases of joints other than the knees (OR 2.0187) and asthma/COPD (OR 2.1679). Os teoarthritis of the knees also increased the risk of sub-optimal overall he alth (OR = 1.7927). Conclusions. Depression was the most disabling disease, and osteoarthritis of the knee had more impact on the HRQOL than many other chronic diseases. The lack of adverse effects of diabetes mellitus and heart disease on the H RQOL of Chinese patients deserves further studies.