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G. V. Rens, III, R. M. A. van Nispen, J. G. J. Hoeijmakers, M. R. de Boer; Self-Reported Comorbidity Is Inaccurately Reported Bij Visually Impaired Adults. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3157. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine accurateness of visually impaired Dutch elderly patients’ comorbidity reports, agreement was investigated with their general practitioners’ (GP) reports. Associations between comorbidity and quality of life (QOL) were studied to assess disease burden.
Comorbidity was assessed of twelve coexisting conditions at baseline from 296 patients and 165 GPs. Agreement was assessed with Cohen’s Kappa. QOL was measured with the EuroQol 5D (EQ-5D) at baseline and five months follow-up. Associations were analyzed with linear regression models, which were corrected for confounding and regression to the mean.
Patients reported a mean number of coexisting diseases of 1.3 (Sd: 1.0) and their GPs 2.7 (Sd:1.6). Kappa statistics were moderate for COPD/asthma (0.6) and heart conditions (0.5) and high for diabetes (0.8). Kappas were lowest (< 0.2) for hypertension, dysfunction of the thyroid gland, chronic allergies, gastrointestinal conditions, chronic skin problems and psychological problems. Having comorbidity, muscular-skeletal problems, cancer or deafness was associated with significantly lower EQ-5D scores at baseline. There was a linear association between the number of coexisting conditions and EQ-5D scores at baseline and after five months. Stroke was associated with lower EQ-5D scores after five months.
Visually impaired elderly patients frequently suffer from coexisting conditions other than their eye disease, which they do not seem to accurately report. Ophthalmologists should be aware that self-reported comorbidity and specific coexisting conditions are related to a worse QOL and that having several conditions or stroke leads to a further decline in QOL after half a year.
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