OBJECTIVES

: Multi-morbidity is defined as the co-occurrence of 2+ chronic conditions within an individual. Especially in ageing populations the burden of multi-morbidity is increasing. A large number of studies have shown that reduced Quality of Life(QoL) is one of the consequences of multi-morbidity. Comparison is difficult due to differences in measuring multi-morbidity and QoL. The objective here is to summarise available evidence across measures of QoL using hierarchical Bayesian-Meta-Analysis.

METHODS

: Studies evaluating the impact of multi-morbidity on QoL were identified in a systematic-literature-review. Inclusion is restricted to studies measuring multi-morbidity as the number of conditions and QoL measures used in a minimum of 3 studies. The outcome of interest was the linear slope relating multi-morbidity with QoL. A Bayesian MA model was fitted in WinBUGs. A 3-level model accounting for different measures of QoL was used to determine the overall impact of multi-morbidity on QoL.

RESULTS

: CONCLUSIONS

: This analysis confirms the significant negative impact of multi-morbidity on QoL. The 3-level model allows us to combine evidence from a large number of studies, while accounting for the heterogeneity of multiple outcome measures. The overall slope indicates a reduction in QoL in general; estimates for the different measures are also given, benefiting from borrowing strength across outcomes. This is particularly useful for outcomes with little evidence.