Assessing the Quality of Life in Patients with Complex Chronic conditions Cronimad Study

Background: People’s life expectancy has increased significantly in the past few decades, which has been associated with an increased prevalence of chronic diseases. Chronic-complex patients (CCP), including those characterized as polypathological patients (PPP), are now the majority among chronic patients and are considered a priority group in healthcare settings. This study aimed to determine the health-related quality of life (QoL) of Spanish CCP and its association with sociodemographic, clinical and functional variables and cognitive status. Methods: Patients identified as CCP or PPP from six hospitals in the Community of Madrid were included. The primary endpoint was to determine the QoL of CCP/PPP. To do so, patients were asked to complete the EuroQol questionnaire that included the visual analog scale (EQ-VAS), and the questionnaire with 5 dimensions and 5 levels (EQ-5D-5L). Several socio-demographic/health-related variables were further evaluated and correlated with QoL. Results: A total of 128 CCP/PPP were included. A median EQ-VAS score of 60.0 [45.0, 80.0, and 0.64 [0.40, 0.79] on the EQ-5D-5L Index were observed. The FRAIL Index showed a significant negative correlation with both the EQ-5D-5L (ρ = -0.50; p < 0.001) and EQ-VAS (ρ = -0.30; p = 0.020). Similarly, moderate to extreme pain was associated with lower QoL in both indexes (ρ = -0.55; p < 0.001 for EQ-5D-5L; ρ = -0.36; p < 0.001 for EQ-VAS), as were walking disturbances (ρ = -0.50; p < 0.001 for EQ-5D-5L; ρ = -0.28; p = 0.045 for EQ-VAS). Conversely, the MNA-SF Index showed a significant positive correlation with both the EQ-5D-5L (ρ = 0.36; p = 0.001) and EQ-VAS (ρ = 0.39; p < 0.001). Additionally, the Barthel Index was positively associated with QoL as measured by EQ-5D-5L (ρ = 0.47; p < 0.001). Conclusion: This study suggests that CCP/PPP experience a significantly lower QoL compared to those of the same age. This decline may be influenced by factors such as functional dependence and potentially reversible conditions, including frailty, malnutrition, and pain. All of this highlights the need for a comprehensive assessment that allows for early diagnosis of these conditions and the implementation of multidimensional interventions to prevent functional dependence and activities of daily living. Trial registration: Not applicable