Analytical Assessment of Drug Therapy Burden and Patient-Reported Outcomes in Patients with Multimorbidity in Enugu State

Multimorbidity and the associated polypharmacy impose a treatment burden on patients that affects their physical and emotional capacity to engage with self-management, yet systematic analytical evidence on treatment burden and its relationship with patient-reported outcomes in Nigerian populations is scarce. This study analytically assessed drug therapy burden and its relationship with health-related quality of life and medication adherence in patients with multimorbidity at a university teaching hospital in Enugu State, South East Nigeria. A cross-sectional analytical study was conducted among 180 adult outpatients with two or more chronic conditions and five or more prescribed medications. Treatment burden was assessed using the validated Treatment Burden Questionnaire (TBQ), health-related quality of life by the EQ-5D-5L instrument, and medication adherence by the MMAS-8. Pearson correlations and linear regression examined relationships between treatment burden, quality of life, and adherence scores. Results showed that 52.2 percent of patients reported high treatment burden (TBQ above 50). Treatment burden was significantly negatively correlated with EQ-5D-5L utility scores (r = -0.58; p < 0.001) and positively correlated with non-adherence (r = 0.49; p < 0.001). Polypharmacy count, monitoring frequency, and out-of-pocket medication costs were the strongest treatment burden contributors. The study provides original evidence on treatment burden as a clinically important determinant of patient outcomes in Nigerian multimorbidity patients and recommends deprescribing interventions and simplified monitoring schedules to reduce treatment burden. Keywords: treatment burden, multimorbidity, polypharmacy, patient-reported outcomes, Enugu State