Chronic conditions, multimorbidity, and quality of life among patients attending monk healers and primary care clinics in Thailand

Abstract Background The study aimed to assess chronic diseases, multimorbidity, and QoL among patients attending two different treatment settings in Thailand. Methods In all, 1409 attendees of three monk healer or three health centres were assessed with self-reported measures on chronic conditions and Quality of Life (QoL). Results Results indicate that the most common chronic conditions were common mental disorder (25.2%), followed by hypertension (22.8%), high blood cholesterol (18.0%), fatigue disorder (14.4%), diabetes (14.0%), migraine headaches (13.7%), sleeping problem (12.2%), and ulcer (11.0%). In all, 40.6% had multimorbidity (two or more chronic conditions) (42.4% in the monk healer and 38.9% in the primary care setting). In ANCOVA analysis, adjusted for sex, age, employment status, marital status, education, economic status, comorbidity, and health care setting, the poorest overall QoL was found among clients with common mental disorders (58.5 mean score), followed by emphysema or asthma (60.2), sleeping problem (61.5), migraine headaches (62.7), fatigue disorder (63.3), substance use disorder (63.6) and ulcer (64.3). The overall QoL was poorer among monk healer clients (66.5) than primary care patients (68.8). In adjusted logistical regression analysis, being a monk healer attendee, older age (55–93 years), and high debt were positively, and being employed and better overall quality of life were negatively associated with multimorbidity, overall, for the monk healer and primary care setting. In adjusted linear regression analyses, primary health care attenders, older age, were employed and post-secondary education increased the odds of better overall QoL. Conclusion Multimorbidity was higher among clients attending monk healers than those attending primary care facilities and QoL was poorer among clients seeking care from monk healers than those attending primary care. High multimorbidity was found and major chronic conditions were found to have poor QoL. Determinants of multimorbidity and QoL in two different treatment settings provide information to improve the management of chronic conditions.

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Assessment of impact of ARIA guideline implementation vs routine care on rhinitis related quality of life in a primary care setting in Ireland

10.26226/morressier.5acc8ad0d462b8028d89ab27 ◽

2018 ◽

Author(s):

Anne Marie McGinley

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Care Setting ◽

Primary Care Setting ◽

Guideline Implementation ◽

Routine Care ◽

Related Quality

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Migraine Education Improves Quality of Life in a Primary Care Setting

Headache The Journal of Head and Face Pain ◽

10.1111/j.1526-4610.2010.01618.x ◽

2010 ◽

Vol 50 (4) ◽

pp. 600-612 ◽

Cited By ~ 34

Author(s):

Timothy R. Smith ◽

Robert A. Nicholson ◽

James W. Banks

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Care Setting ◽

Primary Care Setting

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Screening for depression in diabetes in an Indian primary care setting: Is depression related to perceived quality of life?

Primary Care Diabetes ◽

10.1016/j.pcd.2020.03.002 ◽

2020 ◽

Vol 14 (6) ◽

pp. 709-713

Author(s):

Suravi Patra ◽

Binod Kumar Patro ◽

Manaswini Mangaraj ◽

Soumya Swaroop Sahoo

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Care Setting ◽

Primary Care Setting ◽

Perceived Quality ◽

Perceived Quality Of Life

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Diagnosis and management of gastroesophageal reflux disease in the primary care setting: can health-related quality of life play a role?

The American Journal of Gastroenterology ◽

10.1016/s0002-9270(01)02586-2 ◽

2001 ◽

Vol 96 (8) ◽

pp. S54-S56 ◽

Cited By ~ 3

Author(s):

I GRALNEK

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Care Setting ◽

Primary Care Setting ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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A Web-Based eHealth Intervention to Improve the Quality of Life of Older Adults With Multiple Chronic Conditions: Protocol for a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/25175 ◽

2021 ◽

Vol 10 (2) ◽

pp. e25175

Author(s):

David H Gustafson Sr ◽

Marie-Louise Mares ◽

Darcie C Johnston ◽

Jane E Mahoney ◽

Randall T Brown ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Primary Care ◽

Health Care ◽

Chronic Conditions ◽

Health Care Use ◽

Multiple Chronic Conditions ◽

Secondary Outcomes ◽

Ehealth Intervention

Background Multiple chronic conditions (MCCs) are common among older adults and expensive to manage. Two-thirds of Medicare beneficiaries have multiple conditions (eg, diabetes and osteoarthritis) and account for more than 90% of Medicare spending. Patients with MCCs also experience lower quality of life and worse medical and psychiatric outcomes than patients without MCCs. In primary care settings, where MCCs are generally treated, care often focuses on laboratory results and medication management, and not quality of life, due in part to time constraints. eHealth systems, which have been shown to improve multiple outcomes, may be able to fill the gap, supplementing primary care and improving these patients’ lives. Objective This study aims to assess the effects of ElderTree (ET), an eHealth intervention for older adults with MCCs, on quality of life and related measures. Methods In this unblinded study, 346 adults aged 65 years and older with at least 3 of 5 targeted high-risk chronic conditions (hypertension, hyperlipidemia, diabetes, osteoarthritis, and BMI ≥30 kg/m2) were recruited from primary care clinics and randomized in a ratio of 1:1 to one of 2 conditions: usual care (UC) plus laptop computer, internet service, and ET or a control consisting of UC plus laptop and internet but no ET. Patients with ET have access for 12 months and will be followed up for an additional 6 months, for a total of 18 months. The primary outcomes of this study are the differences between the 2 groups with regard to measures of quality of life, psychological well-being, and loneliness. The secondary outcomes are between-group differences in laboratory scores, falls, symptom distress, medication adherence, and crisis and long-term health care use. We will also examine the mediators and moderators of the effects of ET. At baseline and months 6, 12, and 18, patients complete written surveys comprising validated scales selected for good psychometric properties with similar populations; laboratory data are collected from eHealth records; health care use and chronic conditions are collected from health records and patient surveys; and ET use data are collected continuously in system logs. We will use general linear models and linear mixed models to evaluate primary and secondary outcomes over time, with treatment condition as a between-subjects factor. Separate analyses will be conducted for outcomes that are noncontinuous or not correlated with other outcomes. Results Recruitment was conducted from January 2018 to December 2019, and 346 participants were recruited. The intervention period will end in June 2021. Conclusions With self-management and motivational strategies, health tracking, educational tools, and peer community and support, ET may help improve outcomes for patients coping with ongoing, complex MCCs. In addition, it may relieve some stress on the primary care system, with potential cost implications. Trial Registration ClinicalTrials.gov NCT03387735; https://www.clinicaltrials.gov/ct2/show/NCT03387735. International Registered Report Identifier (IRRID) DERR1-10.2196/25175

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The Impact of Telehome Care on Health Status and Quality of Life Among Patients with Diabetes in a Primary Care Setting in Poland

Telemedicine Journal and e-Health ◽

10.1089/tmj.2010.0113 ◽

2011 ◽

Vol 17 (3) ◽

pp. 153-163 ◽

Cited By ~ 46

Author(s):

Maria Magdalena Bujnowska-Fedak ◽

Edward Puchała ◽

Andrzej Steciwko

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Health Status ◽

Care Setting ◽

Primary Care Setting ◽

Patients With Diabetes ◽

The Impact

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Mental health and quality of life benefits of a pedometer-based walking intervention delivered in a primary care setting

Acta Gymnica ◽

10.5507/ag.2017.017 ◽

2017 ◽

Vol 47 (3) ◽

pp. 138-143 ◽

Cited By ~ 2

Author(s):

Tomas Vetrovsky ◽

Jozef Cupka ◽

Martin Dudek ◽

Blanka Kuthanova ◽

Klaudia Vetrovska ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Primary Care ◽

Care Setting ◽

Primary Care Setting ◽

Walking Intervention

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Возможности совершенствования кадрового обеспечения медицинских организаций путем привлечения молодых специалистов

Dalʹnevostočnyj medicinskij žurnal ◽

10.35177/1994-5191-20120-1-70-73 ◽

2020 ◽

pp. 70-73

Keyword(s):

Primary Care ◽

Health Care ◽

Care Setting ◽

Primary Care Setting ◽

Medical Personnel ◽

Practical Training ◽

Medical Worker ◽

Additional Mechanism ◽

Entire Amount

Unfortunately, there is a shortage of medical personnel, and auxiliary staﬀ in many health-care institutions and the situation has been deteriorating. In these conditions, the burden on each medical worker increases; specialists cannot perform an entire amount of work at a proper level. An additional mechanism for replenishment of primary care could be the interaction between medical organizations and universities, aimed at attracting residents who have passed accreditation and are able to work as doctors in their free time. Thus, ﬁrst of all, this cooperation will signiﬁcantly improve the quality of practical training of residents, and it will help residents ﬁnancially because they will receive a salary while working in primary care setting, and simultaneously study in residency.

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