Multiple Chronic Conditions and Multimorbidity among Older Adults in Albania: Prevalence and Impact on Care Needs, Medication Adherence, and Quality of Life

Introduction: Multimorbidity, the coexistence of two or more chronic conditions, is a major global public health challenge and exists on a continuum from non-complex to highly complex, with increasing complexity and multi-system involvement linked to greater instrumental activities of daily living (IADL) disability, frailty, and mortality. Objectives: This study aims (1) to assess chronic condition complexity (CCC) levels by distinguishing multiple chronic conditions (MCCs) from multimorbidity (MM) among older adults in Albania; (2) evaluate their prevalence and impact on care needs, medication adherence, and quality of life; and (3) examine associations between MM and sociodemographic factors, including age, gender, educational level, and medication burden. Methods: An observational, descriptive, cross-sectional, multicenter study with analytical approach was conducted among older adults aged 65 years and older with 2 or more chronic conditions in Albania. Data were collected from participants attending six Primary Health Care Centers located in South of Albania, between March and December 2024. Data were collected using the Simplified Medication Adherence Questionnaire (SMAQ) and the Older People's Quality of Life Questionnaire (OPQOL-35), both of which are validated and reliable tools for the Albanian population. Results: Diagnosis status was significantly associated with age, educational attainment, and medication burden, with older adults experiencing MM more likely to be older, have lower education, use multiple medications, rely on family for care, and exhibit lower medication adherence, underscoring the influence of sociodemographic factors and treatment burden on the health outcomes of older adults.