Purpose: Little is known about the impact of co-morbidities on health-related quality of life (HRQoL) for people with idiopathic pulmonary fibrosis (IPF). We aimed to investigate the relative contribution of co-morbidities to HRQoL of people with IPF.

Methods: N = 157 participants were recruited from the Australian IPF Registry (AIPFR). Health state utilities (HSUs), and the super-dimensions of physical and psychosocial scores were measured using the Assessment of Quality of Life-8-Dimensions (AQoL-8D). The impact of co-morbidities on HRQoL was investigated using linear regression and general dominance analyses.

Results: A higher number of co-morbidities was associated with lower HSUs (p trend = 0.002). Co-morbidities explained 9.1% of the variance of HSUs, 16.0% of physical super-dimensional scores, and 4.2% of psychosocial super-dimensional scores. Arthritis was associated with a significant reduction on HSUs (β =  − 0.09, 95% confidence interval [CI] − 0.16 to − 0.02), largely driven by reduced scores on the physical super-dimension (β =  − 0.13, 95% CI − 0.20 to − 0.06). Heart diseases were associated with a significant reduction on HSUs (β =  − 0.09, 95% CI − 0.16 to − 0.02), driven by reduced scores on physical (β =  − 0.09, 95% CI − 0.16 to − 0.02) and psychosocial (β = -0.10, 95% CI − 0.17 to − 0.02) super-dimensions.

Conclusions: Co-morbidities significantly impact HRQoL of people with IPF, with markedly negative impacts on their HSUs and physical health. A more holistic approach to the care of people with IPF is important as better management of these co-morbidities could lead to improved HRQoL in people with IPF.