title: Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey.
abstract: BACKGROUND
  This study was carried out to compare the HRQoL of patients in general practice with differing chronic diseases with the HRQoL of patients without chronic conditions, to evaluate the HRQoL of general practice patients in Germany compared with the HRQoL of the general population, and to explore the influence of different chronic diseases on patients' HRQoL, independently of the effects of multiple confounding variables.
  
  
  METHODS
  A cross-sectional questionnaire survey including the SF-36, the EQ-5D and demographic questions was conducted in 20 general practices in Germany. 1009 consecutive patients aged 15-89 participated. The SF-36 scale scores of general practice patients with differing chronic diseases were compared with those of patients without chronic conditions. Differences in the SF-36 scale/summary scores and proportions in the EQ-5D dimensions between patients and the general population were analyzed. Independent effects of chronic conditions and demographic variables on the HRQoL were analyzed using multivariable linear regression and polynomial regression models.
  
  
  RESULTS
  The HRQoL for general practice patients with differing chronic diseases tended to show more physical than mental health impairments compared with the reference group of patients without. Patients in general practice in Germany had considerably lower SF-36 scores than the general population (P < 0.001 for all) and showed significantly higher proportions of problems in all EQ-5D dimensions except for the self-care dimension (P < 0.001 for all). The mean EQ VAS for general practice patients was lower than that for the general population (69.2 versus 77.4, P < 0.001). The HRQoL for general practice patients in Germany seemed to be more strongly affected by diseases like depression, back pain, OA of the knee, and cancer than by hypertension and diabetes.
  
  
  CONCLUSIONS
  General practice patients with differing chronic diseases in Germany had impaired quality of life, especially in terms of physical health. The independent impacts on the HRQoL were different depending on the type of chronic disease. Findings from this study might help health professionals to concern more influential diseases in primary care from the patient's perspective.
authors.affiliation: Institute of Social Medicine and Family Medicine, School of Medicine, Zhejiang University, 388 Yuhang Tang Rd., 310058 Hangzhou, PR China. rosa@zju.edu.cn
authors.forename: Hong-Mei
authors.initials: HM
authors.lastname: Wang
authors.forename: Martin
authors.initials: M
authors.lastname: Beyer
authors.forename: Jochen
authors.initials: J
authors.lastname: Gensichen
authors.forename: Ferdinand M
authors.initials: FM
authors.lastname: Gerlach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002908:Chronic Disease / Q000517:prevention & control / Q000523:psychology; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D005858:Germany; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires