Prevalence and patterns of multi-morbidity in the productive age group of 30-69 years: A cross-sectional study in Pathanamthitta District, Kerala.

Abstract

Background: Multi-morbidity is the coexistence of multiple chronic conditions in individuals. With advancing epidemiological and demographic transitions, the burden of multi-morbidity is expected to increase India. Methods: A cross-sectional representative survey was conducted among 410 participants aged 30-69 years in Pathanamthitta District, Kerala to assess the prevalence of multi-morbidity. A multi-stage cluster sampling method was employed to identify households for the survey. We interviewed all eligible participants in the selected households. A structured interview schedule was used to assess socio-demographic variables, behavioral risk factors and prevailing clinical conditions. We used the PHQ-9 questionnaire for depression screening. Further, we conducted active measurements of both blood sugar and blood pressure. Multiple logistic regression was used to identify variables associated with multi-morbidity. Results: Overall, the prevalence of multi-morbidity was 45.4% (95% CI: 40.5-50.3%). Nearly a quarter of the study participants (25.4%) reported only one chronic condition (21.3-29.9%). Further, 30.7% (26.3-35.5), 10.7% (7.9-14.2), 3.7% (2.1-6.0) and 0.2% reported two, three, four and five chronic conditions, respectively. At least one person with multi-morbidity was present in around seven out of ten households (72%, 95% CI: 65-78%). Further, one in five households (22%, 95% CI: 16.7-28.9%) reported more than one person with multi-morbidity. Diabetes and hypertension was the most frequent dyad (30.9%, 95% CI: 26.5-35.7%), followed by hypertension and depression (7.8%, 95% CI: 5.5-10.9%). Diabetes, hypertension and ischemic heart disease was the common triad in males (8.5%, 95% CI: 4.8-14.1%), while it was diabetes, hypertension and depression (6.9%, 95% CI: 4.2-11.1%) in females. Age, sex, and employment status were associated with multi-morbidity. Conclusion: Multi-morbidity is prevalent in one of two participants in the productive age group of 30-69 years. Further, seven of ten households have at least one person with multi-morbidity. The high burden of multi-morbidity calls for integrated management strategies for multiple chronic conditions.

Patients', carers' and healthcare providers' views of patient‐held health records in Kerala, India: A qualitative exploratory study

“…Multiple PHRs posed difficulty in informational continuity for providers, as they may not have up‐to‐date information on all medications/diagnostic tests or other pertinent medical information that aid in preventing medication errors/duplication of tests. Therefore, our findings suggest an increasing risk for patient safety, especially for patients with multiple morbidities who are increasing in prevalence in Kerala 51 and similar LMIC settings. 52 …”