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Author Archives: Marie-Eve Poitras

The Disease Burden Morbidity Assessment (DBMA) by self-report

By Marie-Eve Poitras, RN. M.Sc.

Studies on multimorbidity should rely on valid and robust measurement to assess the disease burden experienced by patients with chronic diseases. There are many instruments designed to measure multimorbidity, however, most of them have to be administered by professionals because of the medical background required to complete them. This is a limitation to using these instruments in large samples of patients either in primary care settings or the general population.

Previous studies have shown that a measure that includes a weighting for severity is a better predictor of patient-related outcomes than a measure based on a simple disease count [1-2]. Severity can be judged on purely clinical grounds by health professionals or on the basis of the illness experienced by patients themselves. However, impact on daily living seems to be best evaluated by the patient because self-reported disease burden correlates with quality of life outcomes more strongly than measures of comorbidity based on other methods of data collection [3].

 The Disease Burden Morbidity Assessment (DBMA) is a self-report questionnaire that seems promising because: 1) it can be administered to large samples of patients and 2) it judges severity on the basis of the illness experienced by patients themselves [3].

 We conducted a study to test and to measure the properties of the French translation of the DBMA (DBMA-Fv). The DBMA-Fv’s properties were similar to its English counterpart as to its median sensitivity and specificity compared to chart reviews. It correlated moderately with an established index of multimorbidity, the Cumulative Illness Rating Scale (CIRS). A high percentage of patients were able to complete the test correctly as a mail questionnaire and it showed high test-retest reliability.

 The article describing the study can be accessed freely on line [4], where the readers can also find both the English and French versions of the DBMA questionnaire as appendices to the paper.

 1. Fortin, M., et al., Comparative assessment of three different indices of multimorbidity for studies on health-related quality of life. Health Qual Life Outcomes, 2005. 3:74.
2.Fortin, M., et al., Relationship between multimorbidity and health-related quality of life of patients in primary care. Qual Life Res, 2006. 15:83-91.
3. Bayliss, E.A., J.L. Ellis, and J.F. Steiner, Subjective assessments of comorbidity correlate with quality of life health outcomes: Initial validation of a comorbidity assessment instrument. Health and Quality of life Outcomes, 2005. 3:51.
4. Poitras, M.-E., et al., Validation of the disease burden morbidity assessment by self-report in a French-speaking population. BMC Health Service Research, 2012. 12:35.