The Association Between Multimorbidity and Health-Related Quality of Life Among Clients 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 individuals’ lives. Poor quality of life (QoL) is one of the major consequences of living with multimorbidity. Although healthcare aims to support multimorbid individuals to achieve better quality of life, little is known about the effect of multimorbidity on quality of life of patients attending chronic outpatient medical care in Ethiopia. Objective s This study aimed to determine the association between multimorbidity and quality of life among clients attending chronic outpatient medical care in Bahir Dar city, Northwest Ethiopia. Methods A multi-centered facility-based study was conducted among 1440 participants aged 40+ years attending chronic outpatient medical care. Two complementary methods (interview and review of medical records) were employed to collect data on sociodemographic characteristics and presence of chronic diseases. We used the short form (SF-12 V2) instrument to measure quality of life. The data were analyzed by STATA V.16 and multivariate partial proportional odds model was fitted to identify covariates associated with quality of life, adjusting for relevant confounding factors. Statistical significance was considered at p-value <0.05. Results 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 quality of life and one fourth (25.8%) of them had moderate quality of life. Advanced age and living with multimorbidity were associated with poor quality of life. Conversely, being female, strong social support, high socioeconomic status, and adequate functioning and satisfaction with care were the variables positively associated with higher categories of quality of life. Conclusion The magnitude of multimorbidity in this study was high and individuals living with multimorbidity had a relatively poor quality of life than those without multimorbidity. Care of people with chronic multiple conditions may need to be oriented to the realities in multimorbidity burden and its implication on quality of life. Interventions targeting modifiable associated factors and studies exploring the longitudinal effect of multimorbidity on quality of life are needed.