HEALTH-RELATED QUALITY OF LIFE AMONG DISPENSARY OBSERVATION PATIENTS WITH CHRONIC ILLNESS IN BULGARIA

  • Teodora Dimcheva Public Health Faculty, Medical University of Plovdiv, Bulgaria
  • Boryana Levterova Faculty of Public Health, Medical University of Plovdiv, Bulgaria
  • Desislava Bakova Faculty of Public Health, Medical University of Plovdiv, Bulgaria
  • Nonka Mateva Public Health Faculty, Medical University Plovdiv, Bulgaria
Keywords: Health Related Quality Of Life, Chronic Non-Communicable Diseases (NCDs), Bulgaria

Abstract

Introduction: The prevalence of chronic non-communicable diseases (NCDs) worldwide acquires epidemic dimensions. In Europe, five nosological groups (diabetes mellitus, cardiovascular disease, cancer, chronic respiratory diseases and mental disabilities) constitute 77% of NCDs and cause about 86% of deaths in the region.

Objectives: This study aimed to assess the quality of life in patients with chronic non-communicable diseases under dispensary observation.

Methods: The pilot cross-sectional study was performed among adult with chronic diseases in primary care practices in the Plovdiv district (the second largest in Bulgaria) from May to June 2013.

Results: A total of 200 adults with chronic diseases participated in the study. The mean age was 55.6 years (range 25–95, standard deviation (SD) 16.9). The most common chronic diseases in our study were cardiovascular 51% (ischemic heart disease, hypertension, etc.), followed by endocrinology diseases (23%). There was statistically significant differences in the assessments of "general health" in different groups of participants by gender (χ2 = 16.65, P <0.002), age (χ2 = 12.57, P <0.05) and social status (χ2 = 28.54, P <0.0001).

Conclusion: The subjective assessment of health is a factor that has a strong impact on the quality of life of patients and is an important component in evaluating the effectiveness of provided health care for patients with chronic non-communicable diseases.

References

Arnold, R., Ranchor, A., Sanderman, R., Kempen, G., Ormel, J., Suurmeijer, T. (2004). The relative contribution of domains of quality of life to overall quality of life for different chronic diseases. Quality of Life Research. 13(5): 883-896. DOI:10.1023/B:QURE.0000025599.74923.f2.

Bradley, C. (2001). Importance of differentiating health status from quality of life. The Lancet. 357:7-8. DOI: 10.1016/S0140-6736(00)03562-5.

Busse, R., Blümel, M., Scheller-Kreinsen, D., Zentner, A. (2010). Tackling chronic disease in Europe: strategies, interventions and challenges. No. 20. WHO Regional Office Europe. Available from: http://www.euro.who.int/__data/assets/pdf_file/0008/96632/E93736.pdf.

CDC. Measuring Healthy Days. Atlanta, Georgia: CDC; 2000. Available from: https://www.cdc.gov/hrqol/pdfs/mhd.pdf

Dimcheva, T., Foreva, G., Аsenova, R., Маteva, N., Stoev, T., Dimova, R. (2015). The role of patients in the management of chronic diseases: results of the focus-group study. European Medical, Health and Pharmaceutical Journal. 8(2). DOI: http://dx.doi.org/10.12955/emhpj.v8i2.690.

Dimcheva, T., Mateva, N. (2015). Non-communicable chronic disease management-good practices and models. International Journal Scientific and Applicative papers. 8(2): 181-185. (In Bulgarian)

Fayers P, Machin D. (2013). Quality of life: the assessment, analysis and interpretation of patient-reported outcomes. John Wiley & Sons.

Finegold, J. A., Asaria, P., & Francis, D. P. (2013). Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations. International Journal of Cardiology, 168(2), 934–945. http://doi.org/10.1016/j.ijcard.2012.10.046.

Fortin, M., Lapointe, L., Hudon, C., Vanasse, A., Ntetu, A. L., & Maltais, D. (2004). Multimorbidity and quality of life in primary care: a systematic review. Health and Quality of Life Outcomes, 2, 51. http://doi.org/10.1186/1477-7525-2-51.

Garratt, A., Schmidt, L., Mackintosh, A., & Fitzpatrick, R. (2002). Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ : British Medical Journal, 324(7351), 1417.

Goodman, R. A., Posner, S. F., Huang, E. S., Parekh, A. K., Koh, H. K. (2013). Defining and Measuring Chronic Conditions: Imperatives for Research, Policy, Program, and Practice. Prev Chronic Dis.10. DOI: http://dx.doi.org/10.5888/pcd10.120239.

Levterova B., Dimitrova D., Raicheva R., Jambov A. (2013). Health needs assessment – Family Physicians’ perspectives on priorities and target groups in primary care practices in Bulgaria. Euras J Fam Med. 2 (1): 19-24.

Levterova B, Foreva G, Dimitrova D, Assenova R. (2014). Use of instruments for assessing the quality of life in chronic diseases in Bulgarian medical practice. General Medicine. 16 (2): 12-18. (In Bulgarian)

Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., … Ezzati, M. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859), 2224–2260. http://doi.org/10.1016/S0140-6736(12)61766-8.

Mateva N, Nonchev B. (2015). Chronic diseases monitoring-key aspects and problems. Knowledge International Journal Scientific and Applicative papers. 8/2: 48-52. (In Bulgarian)

Nutbeam, D. (1998). Health promotion glossary. Health promotion international. 13(4): 349-364.

Ordinance № 39 of November 16, 2004 for prophylactic examinations and dispensary, 01.01.2005 issued by the Ministry of Health, promulgated in State Gazette number 106 of December 3, 2004. (In Bulgarian)

Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York,19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Off. Rec. Wld Hlth Org., 2, 100), and entered into force on 7 April 1948. Amendments adopted by the Twenty-sixth, Twenty-ninth, Thirty-ninth and Fifty-first World Health Assemblies (resolutions WHA26.37, WHA29.38, WHA39.6 and WHA51.23) came into force on 3 February 1977, 20 January 1984, 11 July 1994 and 15 September 2005.The Definition has not been amended since 1948. Available from: http://www.who.int/governance/eb/who_constitution_en.pdf.

WHO. (2008). How can chronic disease management programmes operate across care settings and providers? World Health Organization and World Health Organization, on behalf of the European Observatory on Health Systems and Policies 2008 Copenhagen , Denmark. Available from: http://apps.who.int/gb/archive/pdf_files/WHA53/ResWHA53/17.pdf.

World Health Organization. (2014). Global status report on noncommunicable diseases 2014.

Published
2017-09-24