title: Predictors of health-related quality of life in people with a complex chronic disease including multimorbidity: a longitudinal cohort study.
abstract: Factors that predict the health-related quality of life (HRQoL) of people with complex chronic diseases have not been investigated to date. Determining the impact of disease on daily activities is a factor that is particularly important with this group of people. This study examined the influence of a range of predictors (including the impact of chronic diseases on daily activities), on HRQoL in patients with complex chronic diseases over a 12-month period.
  
  
  
  A longitudinal cohort study was conducted with outcomes measured at baseline, 3, 6 and 12 months post-baseline. Adults attending an Australian community-based rehabilitation service were included. HRQoL was measured using the SF-36 and corresponding preference-based health utility. Predictor variables included sociodemographic factors, disease factors (e.g. impact of diseases on daily activities), intervention factors, psychosocial factors and HRQoL components that were not included as the dependent variable. Linear mixed-effects regression was used to examine the relationship between predictor variables and HRQoL.
  
  
  
  Data from 351 participants were included. The impact of chronic disease on daily activities was the most frequent significant predictor of HRQoL outcomes. Other significant predictors included the impact of chronic back pain or sciatica on daily activities, the number of comorbidities, general health functioning and psychological distress.
  
  
  
  Models of health care for people with complex chronic disease may be enhanced by greater focus on patients' daily activities during assessment and intervention delivery. The range of significant predictors highlights the importance of an interdisciplinary team for managing complex chronic disease or targeted intervention strategies.
authors.affiliation: Central Queensland Hospital and Health Service, Rockhampton, QLD, Australia. z.tyack@uq.edu.au.|Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia. z.tyack@uq.edu.au.|Centre for Functioning and Health Research, Metro South Health, Buranda, QLD, Australia. z.tyack@uq.edu.au.
authors.forename: Zephanie
authors.initials: Z
authors.lastname: Tyack
authors.affiliation: Central Queensland Hospital and Health Service, Rockhampton, QLD, Australia.
authors.forename: Kerrie-Anne
authors.initials: KA
authors.lastname: Frakes
authors.affiliation: Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia.
authors.forename: Adrian
authors.initials: A
authors.lastname: Barnett
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Mt Gravatt, QLD, Australia.|The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, QLD, Australia.
authors.forename: Petrea
authors.initials: P
authors.lastname: Cornwell
authors.affiliation: The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, QLD, Australia.|School of Physiotherapy, Australian Catholic University, Banyo, QLD, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Kuys
authors.affiliation: Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia.|Centre for Functioning and Health Research, Metro South Health, Buranda, QLD, Australia.
authors.forename: Steven
authors.initials: S
authors.lastname: McPhail
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Chronic disease; Comorbidity; Health-related quality of life; Interdisciplinary; Multimorbidity; Rehabilitation