Variations in health-related quality of life of patients with long-term medical conditions in Nigeria: Implications for an all-inclusive system support

Abstract

Objective: To measured and compared health-related quality of life (HRQOL) among hypertensive (HYP) and human immunodeficiency virus (HIV) patients at tertiary health facility
Design: Comparative cross-sectional study.
Setting: The medical outpatient clinic of the University of Port Harcourt Teaching Hospital in Nigeria.
Subject: Systematic recruitment of 300 HYP and HIV patients; self-reported assessment of the HRQOL using the WHOQOL-BREF questionnaire
Main outcome measures: HROQL along domains of the WHOQOL-BREF questionnaire – general, physical health, psychological health, social and environmental health.
Data analysis: Exploratory and confirmatory data analyses were conducted using Statistical Package for Social Science version 23 and p-value ≤ 0.05 were considered significant.
Result: Response rate was 98% and Cronbach’s alpha was 0.882. About 29.3% and 24.7% reported poor HRQOL for HYP and HIV patients respectively. The mean differences in the HRQOL between HYP and HIV patients along physical, psychological, social, environmental domains and overall HRQOL were physical -15.3(95%CI: -17.2, -13.4, p<0.0001); psychological -17.0(95%CI: -18.9, -15.1, p<0.0001); social 4.2(95%CI: -1.0, 7.4, p = 0.01); environmental -12.6(95%CI: -15.1, -10.1, p<0.001) and overall HRQOL -10.0(95%CI: -11.9, -8.1, p<0.001) respectively. Except for the general health and social domains, HIV patients reported significantly better HRQOL than patients with hypertension.
Conclusion: The HRQOL of hypertensives was poorer than HIV patients in most domains of the WHOQOL-BREF instrument. Findings call for more clinical, social and environmental support for all patients with LTMCs especially those with non-communicable diseases like hypertension who currently enjoy no subsidy.

Key words: Health-Related Quality of Life, HRQOL, WHOQOL-BREF, hypertension, human immunodeficiency virus patients, HIV, tertiary hospital, UPTH.