Background
Studies on the prevalence of multimorbidity, defined as having two or more chronic conditions, have predominantly focused on the elderly. We estimated the prevalence and specific patterns of multimorbidity across different adult age groups. Furthermore, we examined the associations of multimorbidity with socio-demographic factors.
Methods
Using data from the Health Quality Council of Alberta (HQCA) 2010 Patient Experience Survey, the prevalence of self reported multimorbidity was assessed by telephone interview among a sample of 5010 adults (18 years and over) from the general population. Logistic regression analyses were performed to determine the association between a range of socio-demographic factors and multimorbidity.
Results
The overall age- and sex-standardized prevalence of multimorbidity was 19.0% in the surveyed general population. Of those with multimorbidity, 70.2% were aged less than 65 years. The most common pairing of chronic conditions was chronic pain and arthritis. Age, sex, income and family structure were independently associated with multimorbidity.
Conclusions
Multimorbidity is a common occurrence in the general adult population, and is not limited to the elderly. Future prevention programs and practice guidelines should take into account the common patterns of multimorbidity.
Pain or discomfort is a common problem in people living with chronic conditions, and the existence of multimorbidity in these individuals is associated with a reduction in the HRQL as well as frequent hospitalization and emergency department visits.
BackgroundThe role of obesity in the prevalence and clustering of multimorbidity, the occurrence of two or more chronic conditions, is understudied. We estimated the prevalence of multimorbidity by obesity status, and the interaction of obesity with other predictors of multimorbidity.MethodsData from adult respondents (18 years and over) to the Health Quality Council of Alberta 2012 Patient Experience Survey were analyzed. Multivariable regression models were fitted to test for associations.ResultsThe survey sample included 4803 respondents; 55.8% were female and the mean age was 47.8 years (SD, 17.1). The majority (62.0%) of respondents reported having at least one chronic condition. The prevalence of multimorbidity, including obesity, was 36.0% (95% CI, 34.8 – 37.3). The prevalence of obesity alone was 28.1% (95% CI 26.6 – 29.5). Having obesity was associated with more than double the odds of multimorbidity (odds ratio = 2.2, 95% CI 1.9 – 2.7) compared to non-obese.ConclusionsThe prevalence of multimorbidity in the general population is high, but even higher in obese than non-obese persons. These findings may be relevant for surveillance, prevention and management strategies for multimorbidity.
BackgroundStudies comparing the measurement properties of EQ-5D 3L (3L) and EQ-5D 5L (5L) are limited to specific patient populations with small sample sizes. Using a general population sample, we compared 3L and 5L in terms of their measurement properties and association with number of chronic conditions, including multimorbidity – the concurrent occurrence of two or more chronic conditions.MethodsData were available from two consecutive cycles of a cross-sectional telephone interview survey using 3L (2010 cycle) and 5L (2012 cycle), in the general population of adults (age ≥ 18 years) in Alberta, Canada. Measurement properties were compared by determining their feasibility, ceiling effect, and discriminatory power (Shannon indices) for 3L and 5L. Linear regression models were fitted to test the associations between multimorbidity and EQ-5D index score.ResultsData were available for 4946 (2010) and 4752 (2012) survey respondents with information on HRQL. Compared to 3L, 5L showed lower ceiling effect (32.3% versus 42.1%), higher absolute discriminatory power (Shannon index, mean 0.79 versus 0.52) and higher relative discriminatory power (Shannon Evenness index, mean 0.09 versus 0.06 for 3L). Despite these differences, similar relationships of lower HRQL with greater multimorbidity were observed for the 3L (ß = −0.13, 95% CI −0.15; −0.11) and 5L (ß = −0.12, 95% CI −0.13; −0.11).ConclusionsUsing a general population sample, the EQ-5D 5L showed better measurement properties than the EQ-5D 3L. Nonetheless, clinically important differences in HRQL associated with multimorbidity were similar in magnitude using both versions of EQ-5D.
Higher neighbourhood-level material and social deprivation is significantly associated with lower health-related quality of life in the general adult population. Examining the factors leading to this inequity in health between individuals living in the least and most deprived neighbourhoods is imperative to mitigating these inequities.
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