Rhys, Gwydion Cai (2019) The role of deprivation and quality of care on healthy ageing in older people with musculoskeletal pain: a prospective study. Masters thesis, Keele University.

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Abstract

Background: Musculoskeletal pain is common in older adults and is associated with a decrease in the Healthy Ageing Index (HAI) (a validated composite ageing measure). Deprivation measures were not included in the HAI. The literature advocates including measures of deprivation in ageing models and a literature review illustrated the need to investigate the relationship between deprivation {individual level deprivation (ILD), area level deprivation (ALD), access to care (ATC) and quality of care (QOC)} and healthy ageing in older people with musculoskeletal pain.

Methods: 2949 adults from six general practices aged ≥50 years with complete questionnaires at baseline, 3 and 6 years were analysed. Subject HAI scores (higher scores indicated healthier ageing) were calculated. The questionnaire provided ILD data. ALD was measured using the Index of Multiple Deprivation, ATC by GP Patient Survey and QOC by Quality Outcomes Framework data. Aims: determine whether HAI scores differ by levels of deprivation and establish if associations exist between pain and healthy ageing, and if they are moderated by deprivation at baseline and across 6 years.

Results: HAI scores were lower (and associations noted after adjustment for confounders) with greater deprivation across ILD, ALD, ATC and QOC variables at baseline and over 6 years. There were significant interactions between widespread pain and; ILD, ALD, ATC and QOC variables at baseline and ILD and ALD variables over 6 years, translating to significant reductions in healthy ageing.

Conclusion: Healthy ageing decreases with pain and deprivation (ILD, ALD, ATC & QOC), demonstrating need to; reduce pains causes, improve treatment, reduce inequality and assess interventions. Deprivation variables should be included in ageing models. Assessing whether unaccounted exposures explain poorer ageing amongst particular practice subjects is warranted. Qualitative approaches could investigate reasons for generally lower HAI scores from service users experiencing greater deprivation.

Item Type: Thesis (Masters)
Subjects: R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Contributors: Wilkie, R (Thesis advisor)
Depositing User: Lisa Bailey
Date Deposited: 26 Aug 2020 13:37
Last Modified: 26 Aug 2020 13:37
URI: https://eprints.keele.ac.uk/id/eprint/8596

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