RT Journal Article
SR Electronic
T1 Identifying clusters of mutiple long term conditions and their associations with health related quality of life
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 5006
DO 10.1370/afm.22.s1.5006
VO 21
IS Supplement 3
A1 Jani, Bhautesh
A1 Mair, Frances
A1 Steell, Lewis
A1 Taylor, Rod
A1 Ahmed, Sayem
A1 Singh, Sally
A1 Dibben, Grace
YR 2023
UL http://www.annfammed.org/content/21/Supplement_3/5006.abstract
AB Context: People living with multiple long-term conditions (MLTCs) are a heterogenous population and classifying MLTCs Identifying clusters of LTCs and their differential associations with health and healthcare outcomes may facilitate development of targeted interventions and services.Objective: Identify age-stratified clusters of MLTCs and investigate their associations with health-related quality of life (HRQoL). Compare the associations between HRQoL with MLTC clusters and LTC counts, respectively.Design & datasets: Prospective cohort; UK Biobank (n = 502,503, aged 37 - 73) & the UK Household longitudinal study (UKHLS; n = 50,994, aged 18 – 101).Analyses: Step 1: Apply latent class analysis (LCA) to identify clusters of MLTCs among people with ≥2LTCs, stratified by age (young [18 −36y], middle-aged [37-54y], early-old [55-73y] & older [74+y] adults). Step 2: Tobit regression assessed associations of MLTC clusters and LTC counts with HRQoL, adjusted for sociodemographic covariates & baseline HRQoL.Outcome: HRQoL assessed using EQ-5D Index ScoresResults: MLTC clusters differed across age strata. Depression was prevalent in clusters in young/middle-aged adults. Painful conditions, arthritis, and hypertension were prominent in clusters across middle-aged/early-old/older adults. All MLTC clusters were associated with lower HRQoL compared to no multimorbidity. In young/middle-aged adults, three clusters with depression as an anchoring LTC (i.e. >50% prevalence) were associated with large deficits in HRQoL (beta coefficients: −0.134 to −0.101). High prevalence of painful conditions and arthritis were associated with lower HRQoL across several MLTC clusters from middle-age onwards. In UKHLS only, clusters with high prevalence of heart disease were identified in middle-aged/early-old/older adults and were associated with the worst HRQoL scores at follow up (beta coefficients: −0.294, −0.143 & −0.104, respectively). Associations between LTC counts and HRQoL revealed poorer HRQoL scores in all age-groups as number of LTCs increased. For middle-aged/early-old adults, ≥4 LTCs was associated with greater deficit in HRQoL than any MLTC cluster. In young adults, similar associations were found for ≥3 LTCs.Conclusions: The magnitude of negative association between MLTC clusters and HRQoL depends on age and composition of co-existing LTCs. MLTC clusters should be considered in the development of interventions targeting improvements in HRQoL.