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

Abstract

Purpose The aim of this study was to investigate treatment burden and its relationship with health-related quality of life (HRQoL) among patients with multimorbidity (two or more chronic diseases) who were taking prescription medications and attending the outpatient department of the University of Gondar Comprehensive Specialized Teaching Hospital. Methods A cross-sectional study was conducted between March 2019 and July 2019. Treatment burden was measured using the Multimorbidity Treatment Burden Questionnaire (MTBQ), while HRQoL was captured using the Euroqol-5-dimensions-5-Levels (EQ-5D-5L). Results A total of 423 patients participated in the study. The mean global MTBQ, EQ-5D index, and EQ-VAS scores were 39.35 (± 22.16), 0.83 (± 0.20), and 67.32 (± 18.51), respectively. Significant differences were observed in the mean EQ-5D-Index (F [2, 81.88] 33.1) and EQ-VAS (visual analogue scale) scores (F [2, 75.48] = 72.87) among the treatment burden groups. Follow up post-hoc analyses demonstrated significant mean differences in EQ-VAS scores across the treatment burden groups and in EQ-5D index between the no/low treatment burden and high treatment burden, as well as between the medium treatment burden and high treatment burden. In the multivariate linear regression model, every one SD increase in the global MTBQ score (i.e., 22.16) was associated with a decline of 0.08 in the EQ-5D index (β − 0.38, 95%CI − 0.48, − 0.28), as well as a reduction of 9.4 in the EQ-VAS score (β − 0.51, 95%CI -0.60, − 0.42). Conclusion Treatment burden was inversely associated with HRQoL. Health care providers should be conscious in balancing treatment exposure with patients’ HRQoL.

Experts’ Consensus on the Management of Respiratory Disease Syndemic

“…As multi-morbidity becomes more prevalent with age, especially in the elderly population, simplifying medication regimens becomes crucial ( 37 ). Treatment burden, including multiple medication administration, negatively impacts health-related quality of life ( 38 ). Minimizing medication not only reduces treatment burden but also improves patient compliance, decreases the risk of adverse drug interactions, and enables a comprehensive and personalized approach to care.…”

“…Inaccurate prescribing may occur due to the presence of comorbidities (36). As multi-morbidity becomes more prevalent with age, especially in the elderly population, simplifying medication regimens becomes crucial (37). Treatment burden, including multiple medication administration, negatively impacts health-related quality of life (38).…”

Evaluating health-related quality of life in Ethiopia: protocol for systematic review and meta-analysis of EQ-5D-based studies

“…9 The EQ-5D-5L Ethiopia value sets have been more widely available in recent years, which has increased the tool's use in evaluating the HRQoL of Ethiopian patients with a variety of diseases. [10][11][12][13][14][15][16][17] Utility values from this tool have also been used in economic evaluations to help with health decision-making. 18 Ethiopia faces a diverse range of health concerns, encompassing noncommunicable diseases, maternal health problems and infectious diseases such as HIV and tuberculosis.…”