Multimorbidity and adverse longitudinal outcomes among patients attending chronic outpatient medical care in Bahir Dar, Northwest Ethiopia.

Journal: Frontiers in medicine

Volume: 10

Issue: 

Year of Publication: 

Affiliated Institutions:  School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia. Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Abstract summary 

Multimorbidity is becoming more prevalent in low-and middle-income countries (LMICs). However, the evidence base on the burden and its longitudinal outcomes are limited. This study aimed to determine the longitudinal outcomes of patients with multimorbidity among a sample of individuals attending chronic outpatient non communicable diseases (NCDs) care in Bahir Dar, northwest Ethiopia.A facility-based longitudinal study was conducted among 1,123 participants aged 40+ attending care for single NCD ( = 491) or multimorbidity ( = 633). Data were collected both at baseline and after 1 year through standardized interviews and record reviews. Data were analyzed using Stata V.16. Descriptive statistics and longitudinal panel data analyzes were run to describe independent variables and identify factors predicting outcomes. Statistical significance was considered at -value <0.05.The magnitude of multimorbidity has increased from 54.8% at baseline to 56.8% at 1 year. Four percent ( = 44) of patients were diagnosed with one or more NCDs and those having multimorbidity at baseline were more likely than those without multimorbidity to develop new NCDs. In addition, 106 (9.4%) and 22 (2%) individuals, respectively were hospitalized and died during the follow up period. In this study, about one-third of the participants had higher quality of life (QoL), and those having higher high activation status were more likely to be in the higher versus the combined moderate and lower QoL [AOR1 = 2.35, 95%CI: (1.93, 2.87)] and in the combined higher and moderate versus lower level of QoL [AOR2 = 1.53, 95%CI: (1.25, 1.88)].Developing new NCDs is a frequent occurrence and the prevalence of multimorbidity is high. Living with multimorbidity was associated with poor progress, hospitalization and mortality. Patients having a higher activation level were more likely than those with low activation to have better QoL. If health systems are to meet the needs of the people with chronic conditions and multimorbidity, it is essential to understand diseases trajectories and of impact of multimorbidity on QoL, and determinants and individual capacities, and to increase their activation levels for better health improve outcomes through education and activation.

Authors & Co-authors:  Eyowas Fantu Abebe FA Schneider Marguerite M Alemu Shitaye S Getahun Fentie Ambaw FA

Study Outcome 

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Statistics
Citations :  Skou ST, Mair FS, Fortin M, Guthrie B, Nunes BP, Miranda JJ, et al. . Multimorbidity. Nat Rev Dis Primers. (2022) 8:48. doi: 10.1038/s41572-022-00376-4
Authors :  4
Identifiers
Doi : 1085888
SSN : 2296-858X
Study Population
Male,Female
Mesh Terms
Other Terms
Ethiopia;multimorbidity;ordinal regression;panel data;quality of life
Study Design
Longitudinal Study,Descriptive Study,Cross Sectional Study
Study Approach
Country of Study
Ethiopia
Publication Country
Switzerland