Quality of Life Among Patients with Chronic Diseases in General Medical Practice

Abstract

Background. As chronic diseases become the dominant reason for consultation in general medical practice, the goals of care increasingly extend beyond survival and biomarker control to the preservation of health-related quality of life (HRQoL). HRQoL captures the patient’s own experience of physical, psychological, and social functioning, and is a central—if often under-measured—outcome of chronic-disease care in primary settings.

Objective. To synthesise current evidence on HRQoL among patients with chronic diseases in general practice: its conceptual basis and measurement, the impact of single and multiple chronic conditions, the determinants of HRQoL, and the implications for primary-care management.

Methods. We conducted a structured narrative review of peer-reviewed literature and validated instrument documentation, prioritising primary-care and general-population studies and systematic reviews of multimorbidity and HRQoL.

Results. Generic instruments—notably the SF-36 and the EuroQol EQ-5D (with dimensions of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression)—are the most widely used measures, complemented by disease-specific tools. Chronic conditions consistently reduce HRQoL, with anxiety/depression and chronic pain among the largest decrements (each around −0.19 on the EQ-5D index in one general-population study), and multimorbidity produces a graded, cumulative reduction (around −0.12 EQ-5D index) alongside roughly double the odds of hospitalisation. Older age, female sex, lower education and income, unemployment, and conditions such as heart failure and joint disease are associated with poorer HRQoL. Enhanced, team-based primary-care management can improve HRQoL.

Conclusion. HRQoL is a meaningful, measurable outcome that should be integrated into routine chronic-disease care in general practice. Person-centred, multimorbidity-aware management—attentive to mental health, pain, and social circumstances—offers the most realistic route to preserving quality of life.