Different Multimorbidity Measures Result in Varying Estimated Levels of Physical Quality of Life in Individuals with Multimorbidity: A Cross-Sectional Study in the General Population

Introduction. Multimorbidity adversely affects health-related quality of life. Methodological factors may impact the magnitude of this relationship. Objective. To evaluate how physical health-related quality of life varies in individuals with multimorbidity depending on the length of the list of candidate conditions considered. Methods. Secondary analysis from PRECISE, a cohort study of the general adult population of Quebec, Canada. Multimorbidity was measured using the 21-chronic condition list from the Disease Burden Morbidity Assessment, and physical health-related quality of life was measured using the physical component summary (PCS) of SF-12v2. The PCS was calculated, (a) using 2 or more conditions from the 21-condition list (MM2+, 21) and then from a reduced 6-condition list (MM2+, 6) and (b) using three or more conditions from each list (MM3+, 21, and MM3+, 6). Results. The analysis included 1,710 individuals (mean age 51.3, 40.5% men). Multimorbidity prevalence ranged from 63.8% (MM2+, 21 conditions) to 3.8% (MM3+, 6 conditions). The mean [95% CI] PCS dropped from 45.7 [CI: 45.0-46.3] (MM2+, 21) to 40.2 [CI: 38.7-41.8] (MM2+, 6) and from 44.2 [CI: 43.4-44.9] (MM3+, 21) to 34.8 [CI: 31.9-37.6] (MM3+, 6). Conclusion. The length of the list of candidate conditions considered has a great impact on the estimations of physical health-related quality of life.