DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20212760

Prevalence of multimorbidity in Thailand: a multilevel analysis of a population-based survey

Nirun Intarut, Parinya Srihatrai, Narongsak Chantawang

Abstract


Background: The objective of the study was to estimate the prevalence of multimorbidity and to analyze the factors related to multimorbidity using multilevel analysis.

Methods: The data from the 2017 National Health and Welfare Survey was used. In total, 27,960 families and 65,781 participants were analyzed. Multilevel logistic regression analysis with 2-levels was performed to assess independent risk factors for the multimorbidity.

Results: Of 14,353 participants analyzed, 20.4% (95% confidence interval (CI): 20.1, 20.7) of those showed multimorbidity. 59% were females; 74.4% were 56-66 years, 68.7% had primary school level education, and 63.8% were reported being married. Multilevel multiple logistic regression results showed that the prevalence of multimorbidity was higher in females (adjusted OR (AOR): 1.2, 95% CI: 1.1, 1.3), older participants had higher risk of multimorbidity than younger people (p value for trend <0.01), married (AOR: 1.2; 95% CI: 1.0, 1.4), widowed or divorced (AOR: 1.3; 95% CI: 1.1, 1.5).

Conclusions: A high prevalence of multimorbidity in older patients was found. Tailored disease prevention programs and health care provider are needed to design and service for multimorbidity patients.


Keywords


Multimorbidity, Aging, Chronic disease, Multilevel analysis

Full Text:

PDF

References


Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743-800.

Bao XY, Xie YX, Zhang XX, Peng X, Huang JX, Du QF, Wang PX. The association between multimorbidity and health-related quality of life: a cross-sectional survey among community middle-aged and elderly residents in southern China. Health Qual Life Outcomes. 2019;17(1):107.

World Health Organization. Preventing chronic diseases: a vital investment: WHO global report: Geneva. 2005. Available at: https://apps.who.int/iris/handle/10665/43314. Accessed on 26 February 2021.

Birke H, Jacobsen R, Jønsson AB, Guassora ADK, Walther M, Saxild T, Laursen JT, Vall-Lamora MHD, Frølich A. A complex intervention for multimorbidity in primary care: A feasibility study. J Comorb. 2020;10:2235042X20935312.

Heyworth IT, Hazell ML, Linehan MF, Frank TL. How do common chronic conditions affect health-related quality of life? Br J Gen Pract. 2009;59(568):353-8.

World Health Organization, Multimorbidity: Technical Series on Safer Primary Care. Geneva. 2016.

Poirier MJP, Grepin KA, Grignon M. Approaches and Alternatives to the Wealth Index to Measure Socioeconomic Status Using Survey Data: A Critical Interpretive Synthesis. Social Indicators Research. 2020;148(1):1-46.

Rutstein SO, Kiersten J. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro. 2004.

Intarut N, Pukdeesamai P. Socioeconomic Inequality in Concurrent Tobacco and Alcohol Consumption. Asian Pac J Cancer Prev. 2017;18(7):1913-7.

Chongsuvivatwong V. epiDisplay: Epidemiological Data Display Package. 2018. Available at: https://cran.r-project.org/web/packages/epiDisplay/ index.html. Accessed on 24 January 2021.

R Core Team. A Language and Environment for Statistical Computing. R Foundation for Statistical Computing: Vienna, Austria. 2019. Available at: https://www.gbif.org/tool/81287/r-a-language-and-environment-for-statistical-computing. Accessed on 24 January 2021.

Low LL, Kwan YH, Ko MSM, Yeam CT, Lee VSY, Tan WB, Thumboo J. Epidemiologic Characteristics of Multimorbidity and Sociodemographic Factors Associated With Multimorbidity in a Rapidly Aging Asian Country. JAMA Netw Open. 2019;2(11):e1915245.

Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies. J Comorb. 2019;9:2235042X19870934.

Abad-Díez JM, Calderón-Larrañaga A, Poncel-Falcó A, Poblador-Plou B, Calderón-Meza JM, Sicras-Mainar A, et al. Age and gender differences in the prevalence and patterns of multimorbidity in the older population. BMC Geriatr. 2014;14:75.

Alimohammadian M, Majidi A, Yaseri M, Ahmadi B, Islami F, Derakhshan N, et al., Multimorbidity as an important issue among women: results of a gender difference investigation in a large population-based cross-sectional study in West Asia. BMJ Open. 2017;7(5):e013548.

Lay AAR, Nascimento CL, Burgos FC, Huerta ACL, Zeballos RER, Silva VP, et al. Gender Differences between Multimorbidity and All-Cause Mortality among Older Adults. Curr Gerontol Geriatr Res. 2020;7816785.

Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37-43.

Hu RH, Hsiao FY, Chen LJ, Huang PT, Hsu WW. Increasing age- and gender-specific burden and complexity of multimorbidity in Taiwan, 2003-2013: a cross-sectional study based on nationwide claims data. BMJ Open. 2019;9(6):e028333.

Atella V, Piano Mortari A, Kopinska J, Belotti F, Lapi F, Cricelli C, Fontana L. Trends in age-related disease burden and healthcare utilization. Aging Cell. 2019;18(1):e12861.

Prasad S, Sung B, Aggarwal BB. Age-associated chronic diseases require age-old medicine: role of chronic inflammation. Prev Med. 2012;54:29-37.

Stenholm S, Head J, Kivimäki M, Kawachi I, Aalto V, Zins M, et al. Smoking, physical inactivity and obesity as predictors of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Epidemiol. 2016;45(4):1260-70.

Schoeppe S, Vandelanotte C, Rebar AL, Hayman M, Duncan MJ, Alley SJ. Do singles or couples live healthier lifestyles? Trends in Queensland between 2005-2014. PLoS One. 2018;13(2):e0192584.

Molloy GJ, Stamatakis E, Randall G, Hamer M. Marital status, gender and cardiovascular mortality: behavioural, psychological distress and metabolic explanations. Soc Sci Med. 2009 Jul;69(2):223-8.

Arokiasamy, P., et al., The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal? BMC Med. 2015;13:178.

Singer L, Green M, Rowe F, Ben-Shlomo Y, Morrissey K. Social determinants of multimorbidity and multiple functional limitations among the ageing population of England, 2002-2015. SSM Popul Health. 2019;8:100413