Some combinations of long-term health conditions linked to worse quality of life

Certain combinations of long-term health conditions are associated with worse quality of life and should be taken into account when assessing patients.

Recent findings, from a large UK-wide study led by the University of Glasgow suggest that living with chronic pain or depression alongside other long-term health conditions is associated with lower quality of life. The research team propose healthcare settings urgently need new approaches to better treat patients with multiple long-term health conditions.

The study, published in BMC Medicine, is part of the NIHR funded PERFORM (Personalised Exercise-Rehabilitation For people with Multiple long-term conditions (multimorbidity) jointly led by Professor Sally Singh at the University of Leicester and Professor Rod Taylor at the University of Glasgow. 

The research team looked at health data of more than half a million people from both the UK Biobank and the UK Household Longitudinal Study. Researchers were able to identify 24 different multimorbidity clusters – specific groups of long-term health conditions experienced by patients. Some clusters were linked with worse overall quality of life, particularly those associated with chronic pain, depression and cardiovascular disease.

People living with multiple long-term conditions – typically defined as the co-existence of two or more chronic conditions and often referred to multimorbidity – is now an area of major international public health concern. 

Improving treatments, alongside increased life expectancies, and changes in lifestyle behaviours, have fuelled an increase in the number of people living with multimorbidity worldwide. In the UK, approximately 20-40% of adults are living with multiple long-term health conditions, with the figure rising to more than 50% in people aged over 65 years.

People living in socially disadvantaged areas are disproportionately impacted by multimorbidity, with populations in these areas experiencing the onset of multiple long-term health conditions up to two decades earlier than those in the least deprived areas.
However, despite the growing healthcare and economic burden of multiple long-term conditions, healthcare settings remain set-up, as they have always been, to treat single conditions, meaning some patients are receiving inadequate care, further impacting their quality of life.

Dr Bhautesh Jani, Clinical Senior Lecturer and Honorary Consultant at the University of Glagow’s School of Health and Wellbeing, said: “Treatment and monitoring of long-term conditions (sometimes referred as ‘secondary prevention’) is largely organised with a ‘one size fits all’ approach. 

“This study has identified potential combinations of long-term health conditions which often have the worst impact on long-term health related quality of life. People with these combinations may benefit from tailored treatment and monitoring, which in turn may improve their long-term health and quality of life.”

Professor Singh from the University of Leicester added: “This is a valuable analysis of large datasets that helps us understand the impact of combinations of long terms conditions that have the greatest impact on an individuals’ well-being. It is an important piece of work that helps the NIHR PERFORM team identify people most likely to gain from the intervention being tested for people with multiple long-term conditions.”