The increasing prevalence of multimorbidity among older people in Lithuania and other Central-Eastern European countries leads to a greater patient treatment burden and puts additional pressure on healthcare services. This study aimed to validate the Lithuanian version of the Multimorbidity Treatment Burden Questionnaire (MTBQ). The Lithuanian version of the MTBQ was tested (2021-2022) with 789 patients from seven Lithuanian primary care centres who had two or more long-term conditions. The questionnaire translation's reliability, validity and dimensionality of the were assessed with Spearman's rank correlation, Cronbach's alpha, and factor reduction analysis. Treatment burden and its associations with sociodemographic and other indicators were analysed. Lithuanian version of MTBQ had good internal reliability (Cronbach's alpha 0.711), validity, factor reduction applicability, and interpretability. The MTBQ scores of the questionnaire had a negative association with the quality-of-life scale (r=-0.327, 95% CI [-0.389, -0.264]) and positive associations with the self-rated health scores (r = 0.230, 95% CI [0.163, 0.297]) and with the number of comorbidities (r = 0.164, 95% CI [0.097, 0.233]). Distribution of treatment burden was identified (none (19,4%), low (46,6%), medium (25%), high (9%)). High treatment burden was found to be associated with having five or more long-term diseases, taking five or more medications, having anxiety or depression and living in a rural area. The study's findings show that the MTBQ is applicable in assessing the treatment burden of multimorbid patients in Lithuania. Furthermore, the study demonstrates that Lithuanian patients with multimorbidity have average treatment burden scores similar to or higher than participants in previous MTBQ validation studies.

Background and Objectives: Despite the critical importance of effective healthcare management for patients with multimorbidity, robust and reliable tools for assessing health-related quality of life in Lithuania remain scarce. We aim to identify trends in the quality of life of patients with multimorbidity and to evaluate the effectiveness of the Lithuanian version of the EuroQol EQ-5D-5L questionnaire. Materials and Methods: The study included patients between the ages of 40 and 85 (N = 498) who had at least two chronic conditions, arterial hypertension being a prerequisite. The participants completed a comprehensive set of questionnaires specifically prepared for the TELELISPA “Improved healthcare quality for patients with multimorbidity in Lithuania” project which included the translated EQ-5D-5L questionnaire. The predictive validity of the EQ-5D-5L questionnaire was assessed using correlations with the SF-36 and EQ-VAS scores, a random forest regression model. Reliability was evaluated using Cronbach’s alpha and inter-item correlations. Trends in the quality of life in different patient groups were assessed with Chi-square tests. Results: The EQ-5D-5L questionnaire demonstrated high reliability and validity with a Cronbach’s alpha value of 0.737, EQ-5D-5L random forest machine learning regression model RMSE value of 0.1396, and adequate scores from other measures. Lower quality of life was found in patients with multimorbidity who had chronic conditions such as angina pectoris, heart failure, atrial fibrillation, or joint diseases, as well as the patients who were older than 60 years of age, women, or unemployed. Different aspects of quality of life were also significantly negatively impacted by diabetes, asthma, and chronic kidney disease. Heart failure, joint diseases, and older age had the biggest negative effect on quality of life. Conclusions: It is found that the Lithuanian EQ-5D-5L questionnaire is suitable for the assessment of the quality of life in patients with multimorbidity and indicates lower quality of life among those with specific cardiovascular and joint disorder chronic conditions and, in particular, demographic groups.

Background/Objectives: Multimorbidity is an increasing challenge in primary care, particularly in aging populations. The aim of the study was to evaluate the effects of a multidisciplinary, patient-centered complex care TELELISPA model on quality of life, mental health, and treatment burden among patients with multimorbidity in Lithuanian primary care settings. Methods: The study was conducted at seven primary healthcare centers in Lithuania and included all TELELISPA project participants who had at least two chronic health conditions including hypertension. Study participants were randomly assigned to intervention (n = 389) and control groups (n = 400): the intervention group received a coordinated, multidisciplinary care intervention for 15 months, whereas the control group received usual care. In the beginning and the end of the study, participants completed different quality of life, treatment burden and psychological health measures. Results: At the 15-month follow-up, the intervention group reported significantly better psychological health scores across different questionnaires—GAD-7 (p = 0.002), PHQ-9 (p < 0.001), EQ-5D-5L anxiety/depression score (p = 0.044), SF-36 emotional well-being score (p = 0.006). The intervention group also had significantly higher overall EQ-5D-5L quality of life scores (p = 0.02), and a better EQ-5D-5L mobility score (p = 0.036). Intervention group patients reported a reduced treatment burden in monitoring health conditions (p = 0.002), obtaining information about their conditions (p = 0.022), and accessing healthcare during the evenings and the weekends (p = 0.003). The interventions were better received by patients who were younger than 65 years of age, while mixed effects were observed between the groups with different numbers of chronic conditions, with or without polypharmacy, and different durations of education. Conclusions: The implementation of a multidisciplinary, team-based complex care model corresponded with improved psychological well-being, enhanced quality of life, and a partially alleviated treatment burden in patients with multimorbidity. The findings of the study support the wider adoption of integrated care models in aging populations and highlight the need for future studies assessing long-term outcomes and cost-effectiveness.

Background and Objectives: Low-density lipoprotein cholesterol (LDL-C) reduction is critical for cardiovascular disease (CVD) prevention. This study aimed to assess the proportion of patients achieving the LDL-C target in Lithuania and to identify factors associated with target achievement. Materials and Methods: This retrospective study used anonymized health data from the Electronic Health Services and Cooperation Infrastructure Information System (ESPBI IS) in Lithuania. Adults aged ≥40 years with at least one LDL-C measurement in 2023 and no documented cancer diagnosis were included. The primary outcome was the proportion of patients achieving LDL-C < 1.8 mmol/L, the target recommended by the European Society of Cardiology guidelines for high-risk individuals. Univariate logistic regression analysis was conducted to identify factors associated with achieving the LDL-C target. Results: The study included 396,835 patients (mean age, 66.9 years). The mean LDL-C concentration was 3.32 mmol/L, and only 8.1% of patients achieved LDL-C < 1.8 mmol/L. Target achievement was higher among patients in the secondary CVD prevention group compared to primary prevention (20.6% vs. 7.3%). Over half of patients (56.4%) received no lipid-lowering therapy (LLT). Statin monotherapy was the most prescribed LLT (31.3%), while only 2.7% of patients received statin and ezetimibe combination. In logistic regression analysis, secondary prevention status, more frequent cardiologist consultations, and higher LLT prescription frequency were associated with LDL-C target achievement. Compared to patients not receiving LLT, the odds of achieving LDL-C < 1.8 mmol/L were significantly higher in those receiving statin monotherapy (odds ratio [OR]: 3.153, 95% confidence interval [CI]: 3.069–3.240), statin and ezetimibe (OR: 7.631, 95% CI: 7.267–8.013), or statin and antihypertensive (OR: 3.945, 95% CI: 3.803–4.092). Conclusions: LDL-C target attainment remains low in Lithuania, with the underuse of LLT. Broader implementation of guideline-recommended lipid-lowering strategies is needed to improve LDL-C control.