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dc.contributor.authorMavaddat, Nahalen
dc.contributor.authorValderas, Jose Men
dc.contributor.authorvan, der Linde Rianneen
dc.contributor.authorKhaw, Kay-Teeen
dc.contributor.authorKinmonth, Ann-Louiseen
dc.date.accessioned2014-11-20T14:12:38Z
dc.date.available2014-11-20T14:12:38Z
dc.date.issued2014-11-25en
dc.identifier.citationBMC Family Practice 2014, 15:185. doi:10.1186/s12875-014-0185-6en
dc.identifier.issn1471-2296
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/246432
dc.description.abstractBackground: The prevalence of coexisting chronic conditions (multimorbidity) is rising. Disease labels, however, give little information about impact on subjective health and personal illness experience. We aim to examine the strength of association of single and multimorbid physical chronic diseases with self-rated health in a middle-aged and older population in England, and to determine whether any association is mediated by depression and other psychosocial factors. Methods: 25 268 individuals aged 39 to 79 years recruited from general practice registers in the European Prospective Investigation of Cancer (EPIC-Norfolk) study, completed a survey including self-rated health, psychosocial function and presence of common physical chronic conditions (cancer, stroke, heart attack, diabetes, asthma/bronchitis and arthritis). Logistic regression models determined odds of “moderate/poor” compared to “good/excellent” health by condition and number of conditions adjusting for psychosocial measures. Results: One-third (8252) reported one, around 7.5% (1899) two, and around 1% (194) three or more conditions. Odds of “moderate/poor” self-rated health worsened with increasing number of conditions (one (OR = 1.3(1.2–1.4)) versus three or more (OR = 3.4(2.3–5.1)), and were highest where there was comorbidity with stroke (OR = 8.7(4.6–16.7)) or heart attack (OR = 8.5(5.3–13.6)). Psychosocial measures did not explain the association between chronic diseases and multimorbidity with self-rated health.The relationship of multimorbidity with self-rated health was particularly strong in men compared to women (three or more conditions: men (OR = 5.2(3.0–8.9)), women OR = 2.1 (1.1–3.9)). Conclusions: Self-rated health provides a simple, integrative patient-centred assessment for evaluation of illness in the context of multiple chronic disease diagnoses. Those registering in general practice in particular men with three or more diseases or those with cardiovascular comorbidities and with poorer self-rated health may warrant further assessment and intervention to improve their physical and subjective health.
dc.description.sponsorshipEPIC-Norfolk is supported by programme grants from Medical Research Council UK (G9502233, G0300128) and Cancer Research UK (C865/A2883), with additional support from the European Union, Stroke Association, Research into Ageing, British Heart Foundation, Department of Health and Wellcome Trust.
dc.languageEnglishen
dc.language.isoenen
dc.publisherBioMed Central
dc.rightsAttribution 2.0 UK: England & Wales*
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/uk/*
dc.subjectGeneral practice/family medicineen
dc.subjectGeneral Integrated Subjective Health Multimorbidityen
dc.subjectComorbidityen
dc.titleAssociation of self-rated health with multimorbidity, chronic disease and psychosocial factors in a large middle-aged and older cohort from general practice: a cross-sectional studyen
dc.typeArticle
dc.description.versionThis is the final version. It was first published by BioMed Central at http://www.biomedcentral.com/1471-2296/15/185en
prism.number185en
prism.publicationDate2014en
prism.publicationNameBMC Family Practiceen
prism.volume15en
dc.rioxxterms.funderNIHR
dc.rioxxterms.funderMRC
dc.rioxxterms.funderEU
dc.rioxxterms.funderBHF
dc.rioxxterms.funderWellcome Trust
dc.rioxxterms.projectidG9502233
dc.rioxxterms.projectidG0300128
dc.rioxxterms.projectidC865/A2883
dcterms.dateAccepted2014-10-28en
rioxxterms.versionofrecord10.1186/s12875-014-0185-6en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2014-11-25en
dc.contributor.orcidKhaw, Kay-Tee [0000-0002-8802-2903]
dc.identifier.eissn1471-2296
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idMRC (G1000143)
pubs.funder-project-idMRC (G0401527)
pubs.funder-project-idCancer Research UK (A2883)


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Attribution 2.0 UK: England & Wales
Except where otherwise noted, this item's licence is described as Attribution 2.0 UK: England & Wales