Presentation (CTI)

OBJECTIVES: Many chronic diseases are associated with a substantial and sustained impact on patients’ health-related quality of life (HRQoL); however, longitudinal evidence remains fragmented and heterogeneous across diseases and study designs within Spain and Europe. This study aimed to identify and characterize existing evidence on HRQoL in patients with chronic diseases in Spain and Europe, including long-term impact and, where available, comparisons with the general population.
METHODS: A targeted literature review was conducted in PubMed, complemented by Google Scholar. Study selection followed predefined PICOT-based criteria focusing on observational studies and reviews published from 2020 onwards to capture contemporary evidence. Eligible studies included pediatric and adult populations with chronic diseases and reported HRQoL outcomes assessed using routinely used patient or observer-reported outcome and utility instruments.
RESULTS: 762 references were identified, of which 68 met the inclusion criteria. Most studies addressed oncology (~23%), cardiovascular (~17%), neurological (~10%), and digestive (~10%) conditions. Generic PROMs and utility instruments (e.g., SF-36, EQ-5D-5L, SF-12, WHOQoL) were most frequently used, enabling cross-disease comparisons. Across studies, HRQoL assessment most commonly captured physical functioning, emotional well‑being, and social participation domains. In longitudinal studies, worsening HRQoL over time was associated with disease progression, comorbidity burden, and adverse outcomes. Comparisons with the general population were scarce; only a minority included a concurrent healthy control group, while most relied on indirect comparisons against published normative values. Evidence was unevenly distributed across therapeutic areas, with renal, gynecological, rare/genetic, and mental health conditions being underrepresented. Few studies reported follow-up beyond 10 years.
CONCLUSIONS: Chronic diseases are associated with a persistent, multidimensional impairment in HRQoL. Available evidence is limited by relatively short follow-up and scarce studies including direct comparisons with the general population. These findings highlight the need for longitudinal real-world studies using PROMs to capture the long-term impact of chronicity and inform clinical practice and policy-making decisions.