Elizabeth A. Bayliss|J. L. Ellis|John F. Steiner
Barriers to Self-Management and Quality-of-Life Outcomes in Seniors With Multimorbidities
University of Colorado Health|Kaiser Permanente|Kaiser Permanente|University of Colorado Health
purpose persons multiple chronic diseases must integrate selfmanagement tasks potentially interacting conditions attain desired clinical outcomesour goal identify barriers selfmanagement associated lower perceived health status secondarily lower reported physical functioning population seniors multimorbiditiesmethods conducted crosssectional telephone survey 352 health maintenance organization members aged 65 years older minimum coexisting diagnoses diabetes depression osteoarthritisvalidated questions based previous qualitative interviews elicited potential barriers selfmanagement process persons multimorbiditieswe analyzed associations morbidity burden potential barriers selfmanagement 2 outcomes using multivariate linear regression modeling resultsour response rate 47sixtysix percent respondents female 55 aged 65 74 years 45 aged 75 years olderfifty percent reported fair poor healthon average 87 chronic diseasesin multivariate analysis higher level morbidity lower level physical functioning less knowledge medical conditions less social activity persistent depressive symptoms greater fi nancial constraints male sex associated lower perceived health statuspotential barriers selfmanagement signifi cantly associated lower levels physical functioning higher level morbidity greater fi nancial constraints greater number compound effects conditions persistent depressive symptoms higher level patientclinician communication lower incomeconclusions addition morbidity burden specifi c psychosocial factors independently associated lower reported health status lower reported physical functioning seniors multimorbiditiesmany factors amenable intervention improve health outcomes