Sunaib Ismail1, Antony Stanley1, Panniyammakal Jeemon1. 1. Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India.
Abstract
Background: Multimorbidity or co-existence of two or more chronic conditions is common and associated with reduced quality of life and increased risk of death. We aimed to estimate the prevalence and pattern of multimorbidity in primary care settings in Kerala and the associated treatment burden, and quality of life. Methods: A cross-sectional survey was conducted among 540 adult participants in Malappuram District, Kerala. A multi-stage cluster sampling method was employed. Hypertension, diabetes, chronic obstructive pulmonary disease, depression and anxiety screening were done by trained medical professionals. The remaining medical conditions were self-reported by the respondent and verified with patient held health records. The health-related quality of life [HRQoL] was measured using the EQ-5D-5L tool. The MTBQ tool was used for measuring the multimorbidity treatment burden. Logistic regression was used to identify variables associated with multi-morbidity. Results: Overall, the prevalence of multimorbidity was 39.8% (35.7 - 44.1). The prevalence of multimorbidity among men (42.6%) was relatively higher than that in women (38.1%). Lower educational attainment, higher age group, and overweight or obesity status were independently associated with higher prevalence of multimorbidity. The most common pairs of coexisting chronic conditions reported in the study were hypertension and diabetes in males (66.7%) and females (70.8%). All domains of quality of life were impaired in individuals with multimorbidity. Conclusion: Multimorbidity is a norm and affects two of five participants seeking care in primary care settings in Kerala. The social gradient in the prevalence of multimorbidity was evident with higher prevalence in individuals with low educational attainment. Multimorbidity seriously impairs quality of life and increases treatment burden. The focus of management should move beyond individual diseases, and pivot towards interventions targeting multi-morbidity management, with a specific focus for people living in lower socio-economic strata. Copyright:
Background: Multimorbidity or co-existence of two or more chronic conditions is common and associated with reduced quality of life and increased risk of death. We aimed to estimate the prevalence and pattern of multimorbidity in primary care settings in Kerala and the associated treatment burden, and quality of life. Methods: A cross-sectional survey was conducted among 540 adult participants in Malappuram District, Kerala. A multi-stage cluster sampling method was employed. Hypertension, diabetes, chronic obstructive pulmonary disease, depression and anxiety screening were done by trained medical professionals. The remaining medical conditions were self-reported by the respondent and verified with patient held health records. The health-related quality of life [HRQoL] was measured using the EQ-5D-5L tool. The MTBQ tool was used for measuring the multimorbidity treatment burden. Logistic regression was used to identify variables associated with multi-morbidity. Results: Overall, the prevalence of multimorbidity was 39.8% (35.7 - 44.1). The prevalence of multimorbidity among men (42.6%) was relatively higher than that in women (38.1%). Lower educational attainment, higher age group, and overweight or obesity status were independently associated with higher prevalence of multimorbidity. The most common pairs of coexisting chronic conditions reported in the study were hypertension and diabetes in males (66.7%) and females (70.8%). All domains of quality of life were impaired in individuals with multimorbidity. Conclusion: Multimorbidity is a norm and affects two of five participants seeking care in primary care settings in Kerala. The social gradient in the prevalence of multimorbidity was evident with higher prevalence in individuals with low educational attainment. Multimorbidity seriously impairs quality of life and increases treatment burden. The focus of management should move beyond individual diseases, and pivot towards interventions targeting multi-morbidity management, with a specific focus for people living in lower socio-economic strata. Copyright:
Authors: Aram V Chobanian; George L Bakris; Henry R Black; William C Cushman; Lee A Green; Joseph L Izzo; Daniel W Jones; Barry J Materson; Suzanne Oparil; Jackson T Wright; Edward J Roccella Journal: Hypertension Date: 2003-12-01 Impact factor: 10.190
Authors: Sanghamitra Pati; Subhashisa Swain; J André Knottnerus; Job F M Metsemakers; Marjan van den Akker Journal: Health Qual Life Outcomes Date: 2019-07-05 Impact factor: 3.186
Authors: Noe Garin; Ai Koyanagi; Somnath Chatterji; Stefanos Tyrovolas; Beatriz Olaya; Matilde Leonardi; Elvira Lara; Seppo Koskinen; Beata Tobiasz-Adamczyk; Jose Luis Ayuso-Mateos; Josep Maria Haro Journal: J Gerontol A Biol Sci Med Sci Date: 2015-09-29 Impact factor: 6.053
Authors: Fernando J Martinez; Anastasia E Raczek; Frederic D Seifer; Craig S Conoscenti; Tammy G Curtice; Thomas D'Eletto; Claudia Cote; Clare Hawkins; Amy L Phillips Journal: COPD Date: 2008-04 Impact factor: 2.409
Authors: José María Abad-Díez; Amaia Calderón-Larrañaga; Antonio Poncel-Falcó; Beatriz Poblador-Plou; José Manuel Calderón-Meza; Antoni Sicras-Mainar; Mercedes Clerencia-Sierra; Alexandra Prados-Torres Journal: BMC Geriatr Date: 2014-06-17 Impact factor: 3.921
Authors: Antonio Bernabe-Ortiz; Diego B Borjas-Cavero; Jimmy D Páucar-Alfaro; Rodrigo M Carrillo-Larco Journal: Int J Environ Res Public Health Date: 2022-07-30 Impact factor: 4.614