Profile of multimorbidity in outpatients attending public healthcare settings

Abstract

Background: Multimorbidity, the co-occurrence of two or more long-term conditions (LTC) in individuals, is associated with greater healthcare utilization, expenditure, and premature mortality, thus positing a challenge for patients and healthcare providers. Given its sparsely available epidemiological evidence, we aimed to describe the profile of multimorbidity in a representative sample of public healthcare outpatients in India. Methods: A facility-based cross-sectional study was conducted from 1 st July to 31 st December 2015 in Odisha, India. Fifteen public healthcare facilities were selected by stratified random sampling. Data was collected from 1,870 adult outpatients attending these settings using Multimorbidity Assessment Questionnaire for Primary Care (MAQ-PC) tool. Result: Nearly 3/4 th of both women and men outpatients were either obese or overweight. >1/2 had multimorbidity (≥2 LTC) while 1/3 rd had ≥3 LTC. Most prevalent condition was hypertension (63%), followed by chronic backache and arthritis. Cancer and psychiatric illness were least reported. Multimorbidity increased with age group, socioeconomic status, and education level. Females across all age groups had higher reported multimorbidity than males. Diabetes--hypertension was frequently occurring dyad. Both physical and mental component of quality of life was reduced in multimorbidity. Conclusion: Multimorbidity is becoming a norm in healthcare practice with high prevalence in females and older adults. Health services for non-communicable diseases need to include commonly occurring dyads along with health promotion. Higher prevalence in females reinforces the need to incorporate gender differences while studying multimorbidity. Analysis of multimorbidity epidemiology through an equity lens could illuminate the underpinning complexities and heterogeneities of this phenomenon.

Prevalence and correlates of multimorbidity among patients attending AYUSH primary care settings in Delhi-National Capital Region, India

“…Our study found females had a higher likelihood of having multimorbidity, which is consistent with the findings of previous studies done among patients visiting primary care in India [ 28 , 32 ]. In LMICs such as India, women are often vulnerable as they are often economically dependent on other family members.…”

Family-Level Multimorbidity among Older Adults in India: Looking through a Syndemic Lens

“…We found multimorbidity to be associated with urban residents, affluent groups, and Southern India, which is similar with the findings of previous studies conducted among individual-level participants in India [ 32 , 33 ]. Although these findings suggest these groups to have more multimorbidity, it could be due to various other social factors.…”

Epidemiology and impact of chronic disease multimorbidity in India: a systematic review and meta-analysis

“…In LMICs such as India, multimorbidity is on the rise; evident by a recent study that estimated a 55% prevalence among adults attending public healthcare facilities. 5 However, the evidence on multimorbidity burden is scattered across various studies done in either small samples or particular regions, but no study to date has synthesized the national estimates. Although, the high prevalence indicates an additional burden on the already swamped healthcare system, the national estimate of multimorbidity burden could help in evidence based guidance to plan changes to the structure and delivery of primary care.…”