Multimorbidity has a substantial impact on sufferers who report not only poorer health but also adverse impacts on their employment and financial wellbeing compared to the general population, new University of Otago research reveals.
The research published in the latest issue of the New Zealand Medical Journal describes the self-reported health status and experiences of 234 people with two or more long-term health conditions who had been hospitalised over the past five years.
Multimorbidity is the presence of two or more long-term conditions that collectively influence a person's health status, often requiring complex care and management. It is becoming an increasing phenomenon in New Zealand.
Many of the individuals surveyed described their general health as “fair” or “poor” with aggregate scores for their physical and mental health also much lower than the general population. Nearly half (48 per cent) reported accomplishing less than they would have liked as a result of their emotional problems (eg, feeling depressed or anxious) over the previous four weeks.
Of the 119 participants who had been employed in the past five years, many had made changes to their working conditions as a result of their health, including decreasing working hours, taking lighter duties or changing jobs, while some stopped working altogether. A majority (70 per cent) reported their health had affected their productivity over the past week.
Nearly one in five participants reported financial difficulty taking care of all their healthcare needs, including prescriptions, while 24 per cent reported difficulties covering other basic living costs in addition to healthcare costs.
Lead researcher Jeannine Stairmand from the Department of Public Health, University of Otago, Wellington, says the finding that patients with multimorbidity report poorer health than a similar cohort of the general New Zealand population is unsurprising.
“More than half of our study cohort were living with three or more long-term conditions and health-related quality of life scores have been found to decrease as the number of concurrent conditions increases,” Ms Stairmand explains.
However, what was surprising was the finding about financial difficulties, she says.
“Our observation that nearly 20 per cent of participants experienced financial difficulties taking care of their healthcare needs (including prescriptions in addition to basic living costs) was unexpected given the small proportion (12 per cent) of respondents living in most deprived areas.”
The population-based study is among the first to report on the impact of multimorbidity on New Zealand patients in primary care and shows these impacts appear to be greater for Māori and Pacific people.
Ms Stairmand says the results support a partnership approach to improving the lives of people with multimorbidity, including supporting patients to self-manage their conditions; society level support involving support people and employers; and healthcare providers taking person-centred approaches using holistic care models.
The research also adds weight to previous University of Otago research to reconsider prescription costs to better enable optimal self-management to maintain health among people with multimorbidity, she says.
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