Multimorbidity and health-related quality of life among patients attending chronic outpatient medical care in Bahir Dar, Northwest Ethiopia: The application of partial proportional odds model

Abstract

Background Multimorbidity, the presence of two or more chronic non-communicable diseases (NCDs) in a given person affects all aspects of people’s lives. Poor quality of life (QoL) is one of the major consequences of living with multimorbidity. Although healthcare should support multimorbid individuals to achieve a better quality of life, little is known about the effect of multimorbidity on the QoL of patients living with chronic conditions. This study aimed to determine the influence of multimorbidity on QoL among clients attending chronic outpatient medical care in Bahir Dar, Northwest Ethiopia. Methodology A multi-centered facility-based study was conducted among 1440 participants aged 40+ years. Two complementary methods were employed to collect sociodemographic and disease related data. We used the short form (SF-12 V2) instrument to measure quality of life (QoL). The data were analyzed by STATA V.16, and a multivariate partial proportional odds model was fitted to identify covariates associated with quality of life. Statistical significance was considered at p-value <0.05. Principal findings Multimorbidity was identified in 54.8% (95% CI = 52.2%-57.4%) of the sample. A significant proportion (33.5%) of the study participants had poor QoL and a quarter (25.8%) of them had moderate QoL. Advanced age, obesity and living with multimorbidity were the factors associated with poor QoL. Conversely, perceived social support and satisfaction with care were the variables positively associated with better QoL. Conclusion The magnitude of multimorbidity in this study was high and individuals living with multimorbidity had a relatively poorer QoL than those without multimorbidity. Care of people with chronic multiple conditions has to be oriented to the realities of multimorbidity burden and its implication on QoL. It is also imperative to replicate the methods we employed to measure and analyze QoL data in this study for facilitating comparison and further development of the approaches.

Multimorbidity and its associated risk factors among adults in northern Sudan: a community-based cross-sectional study

“…Our study demonstratesa high prevalence (61.6%) of multimorbidity among Sudanese adults; the main factors associated with multimorbidity were increasing age, and being female. The present prevalence (61.6%) of multimorbidity was considerably higher than that reported in certain African countries: Ethiopia (54.8%) [ 9 ], Botswana (5.4%) [ 5 ], and South Africa (3%–23%) [ 3 ]. Similarly, the finding was markedly higher than the overall global prevalence of multimorbidity (37.2%), with the highest prevalence documented in South America (45.7%), North America (43.1%), Europe (39.2%), Asia (35%) [ 4 ] and the Middle East (21.8%) [ 6 ].…”

“…Several studies across the globe [ 4 ] and in countries with fewer resources [ 5 ], Middle East countries [ 6 ] and Sub-Saharan countries [ 5 , 7 ] reported different types of prevalence of multimorbidity. Moreover, the prevalence and patterns of multimorbidity are affected by many factors, such as age, gender, obesity and residential regions [ 3 , 8 , 9 ]. Multimorbidity is associated with a huge burden: feelings of dependency, social rejection, psychological distress and poor medication adherence, quality of care and social and sexual health of patients with financial hardships to access optimal medical services for multimorbidity care.…”

Functional limitation as a mediator of the relationship between multimorbidity on health-related quality of life in Australia: evidence from a national panel mediation analysis

“…The possible explanation is that disabled older adults or those with greater functional limitations have a negative impact on their self-care ability, physiological activities, and social interaction, all of which have a negative impact on their physical and mental health, reducing HRQoL. Multimorbidity, functional limitation, and disability all have a negative impact on HRQoL outcomes ( 26 , 28 , 33 , 34 ). Although it is widely assumed that multimorbidity is associated with poorer HRQoL, the mechanisms through which multimorbidity negatively affects HRQoL through functional limitation or disability have not been thoroughly investigated.…”

“…A number of long-term health conditions were found to have a negative impact on HRQoL after controlling for confounding variables ( 23 , 25 ). Numerous studies have discovered a link between functional limitation and poor HRQoL, with the risk of poor HRQoL increasing as functional limitation increases ( 26 – 28 ). However, it is unclear how much adjusting for functional limitation modifies or reduces the relationship between multimorbidity and HRQoL.…”

Treatment burden and health-related quality of life of patients with multimorbidity: a cross-sectional study

“…Therefore, this study aims to fill the research gap in the existing literature on treatment burden and HRQoL in patients with multimorbidity in LMICs, especially focusing on Ethiopia, where a high burden of multimorbidity has been documented. [ 15 , 17 ] Thereof, the objective of this study was to investigate treatment burden and its relationship with HRQoL among patients with multimorbidity.…”