Predictors for oral and general health outcomes and quality of life among older people attending general practice (GP) clinics in South Australia

2020 ◽  
Author(s):  
Madhan Balasubramanian ◽  
Dominic Keuskamp ◽  
Najith Amarasena ◽  
David Brennan
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Primary Care ◽  
Older People ◽  
Health Outcomes ◽  
General Health ◽  
Chronic Conditions ◽  
Living Arrangement ◽  
South Australia

Abstract Background: As the proportion and number of older people in Australia continue to grow, innovative means to tackle primary care and prevention are necessary to combat the individual, social and economic challenges of non-communicable diseases.Objective: To assess risk factors (or predictors) for oral and general health outcomes and quality of life of older people (75+ yrs.) attending general practice (GP) clinics in South Australia.Methods: Data were collected from older people attending 48 GP clinics in metropolitan South Australia. Age, sex, education, living arrangement, material standards, chronic conditions and nutrition were assessed as risk factors. Global self-rated oral and general health and quality of life (OHIP Severity and EQ-5D Utility) were included as outcome measures.Results: A total of 459 participants completed the study; response rate was 78%. In the adjusted models, high satisfaction with material standards and good nutritional health were positively associated with all four oral and general health measures. Sex (β=-0.07), age (β=-0.09) and number of chronic conditions (β=-0.13) were negatively associated with EQ-5D, while living arrangement (β=0.06) was positively associated. Further, education level (PR:0.78), living arrangement (PR:0.75) and chronic conditions (PR:1.54) were significantly associated with self-rated general health.Conclusion: Satisfaction with material standards and nutritional risk were consistent predictors for oral and general health outcomes and quality of life of older people visiting GP clinics. Primary care teams involving general practitioners, nurses and allied health practitioners are well poised to assess risk factors for older people, and work alongside the dental team.

Fear and depression as remediable causes of disability in common medical conditions in primary care

2015 ◽  
Author(s):  
Michael Von Korff
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Conditions ◽  
Social Role ◽  
Low Back ◽  
Psychological States ◽  
Primary Care Patients

This chapter argues that psychological states, in particular fear and depression, are potentially remediable causes of social role disability among primary care patients. Using chronic low back pain as an example, it considers how recognising and treating depression can improve disability and quality of life for primary care patients with this and many other chronic conditions.

scholarly journals The Impact of Structured Self-Monitoring of Blood Glucose Combined With Intensive Education on HbA1c Levels, Hospitalizations, and Quality-of-Life Parameters in Insulin-Treated Patients With Diabetes at Primary Care in Serbia: The Multicenter SPA-EDU Study

2016 ◽  
Vol 11 (4) ◽  
pp. 746-752 ◽  
Author(s):  
Nebojša M. Lalić ◽  
Katarina Lalić ◽  
Aleksandra Jotić ◽  
Dejan Stanojević ◽  
Dragana Živojinović ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Primary Care ◽  
Blood Glucose ◽  
Self Monitoring ◽  
Intensive Education ◽  
Distress Scale ◽  
The Impact ◽  
Hba1c Levels

Background: We assessed the effect of structured self-monitoring of blood glucose (SMBG), in combination with intensive education, on metabolic control, SMBG frequency, hospitalizations, cardiovascular risk factors, and quality-of-life parameters in patients with insulin-treated diabetes in primary health care settings in Serbia. Methods: This 6-month, observational, noninterventional study, followed 346 insulin-treated diabetes patients (type 1 diabetes [T1D], n = 57; type 2 diabetes [T2D], n = 289) from 28 primary care centers. Patients attended a 10-day course at the specialized educational center and were followed monthly by their primary care physicians. Patients used a simple paper tool to document 3-day, 7-point glucose profiles prior to each monthly clinic visit. Physicians reviewed the completed forms at each visit and used a standardized education program to provide remedial training. Changes in HbA1c levels, SMBG frequency, metabolic risk factors, and Diabetes Distress Scale (DDS) were assessed. Results: Mean (± SD) HbA1c within the full cohort was significantly improved from baseline at 6 months (8.85 ± 1.17% vs 7.91 ± 1.24%, P < .01). Significant increases in average SMBG frequency per week were seen at 6 months versus baseline (14.6/week vs 4.3/week, P < .001). The mean (± SE) number of hospitalizations due to metabolic conditions was significantly lower during the 6-month study compared to the 6-month period prior to the study (0.14 ± 0.04 vs 0.59 ± 0.09). DDS scores decreased from 39.6 ± 13.9 to 33.9 ± 14.5, P < .01. Conclusion: The use of structured SMBG combined with intensive education was associated with clinically significant reductions in HbA1c, increased SMBG frequency, and improved quality of life.

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

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

Oral health, general health, and quality of life in older people

2008 ◽  
Vol 28 (6) ◽  
pp. 224-236 ◽  
Author(s):  
Daniel Kandelman ◽  
Poul Erik Petersen ◽  
Hiroshi Ueda
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Older People ◽  
General Health

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

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Supa Pengpid ◽  
Karl Peltzer
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Care ◽  
Chronic Conditions ◽  
Care Setting ◽  
Primary Care Setting ◽  
Older Age ◽  
Migraine Headaches ◽  
Treatment Settings

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.

Erectile Dysfunction (ED) prevalence, risk factors, comorbid chronic conditions, and quality of life burden in the UK general population

2021 ◽  
Vol 79 ◽  
pp. S649-S650
Author(s):  
T.A. Maguire ◽  
J.Z. Li ◽  
M.C. Maculaitis ◽  
K.H. Zou ◽  
L.J. Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Erectile Dysfunction ◽  
General Population ◽  
Chronic Conditions ◽  
The Uk

scholarly journals Predictors of the quality of life of older people with heart failure recruited from primary care

2006 ◽  
Vol 35 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Merryn Gott ◽  
Sarah Barnes ◽  
Chris Parker ◽  
Sheila Payne ◽  
David Seamark ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Primary Care ◽  
Older People
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