Prevalence of multimorbidity in the Brazilian adult population according to socioeconomic and demographic characteristics

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Knowledge on the occurrence of multimorbidity is important from the viewpoint of public policies, as this condition increases the consumption of medicines as well as the utilization and expenses of health services, affecting life quality of the population. The objective of this study was to estimate prevalence of self-reported multimorbidity in Brazilian adults (≥18 years old) according to socioeconomic and demographic characteristics. A descriptive study is presented herein, based on data from the National Health Survey, which was a household-based survey carried out in Brazil in 2013. Data on 60,202 adult participants over the age of 18 were included. Prevalences and its respective confidence intervals (95%) were estimated according to sex, age, education level, marital status, self-reported skin color, area of residence, occupation and federative units (states). Poisson regression models univariate and multivariate were used to evaluate the association between socioeconomic and demographic variables with multimorbidity. To observe the combinations of chronic conditions the most common groups in pairs, trios, quartets and quintets of chronic diseases were observed. The prevalence of multimorbidity was 23.6% and was higher among women, in individuals over 60 years of age, people with low educational levels, people living with partner, in urban areas and among unemployed persons. The states of the South and Southeast regions presented higher prevalence. The most common groups of chronic diseases were metabolic and musculoskeletal diseases. The results demonstrated high prevalence of multimorbidity in Brazil. The study also revealed that a considerable share of the economically active population presented two or more chronic diseases. Data of this research indicated that socioeconomic and demographic aspects must be considered during the planning of health services and development of prevention and treatment strategies for chronic diseases, and consequently, multimorbidity.

Related collections

Most cited references 24

Record: found
Abstract: found
Article: not found

Multimorbidity in older adults.

M Salive (2013)

Multimorbidity, the coexistence of 2 or more chronic conditions, has become prevalent among older adults as mortality rates have declined and the population has aged. We examined population-based administrative claims data indicating specific health service delivery to nearly 31 million Medicare fee-for-service beneficiaries for 15 prevalent chronic conditions. A total of 67% had multimorbidity, which increased with age, from 50% for persons under age 65 years to 62% for those aged 65-74 years and 81.5% for those aged ≥85 years. A systematic review identified 16 other prevalence studies conducted in community samples that included older adults, with median prevalence of 63% and a mode of 67%. Prevalence differences between studies are probably due to methodological biases; no studies were comparable. Key methodological issues arise from elements of the case definition, including type and number of chronic conditions included, ascertainment methods, and source population. Standardized methods for measuring multimorbidity are needed to enable public health surveillance and prevention. Multimorbidity is associated with elevated risk of death, disability, poor functional status, poor quality of life, and adverse drug events. Additional research is needed to develop an understanding of causal pathways and to further develop and test potential clinical and population interventions targeting multimorbidity. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2013.

0 comments Cited 410 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

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?

Perianayagam Arokiasamy, Uttamacharya Uttamacharya, Kshipra Jain … (2015)

Background Chronic diseases contribute a large share of disease burden in low- and middle-income countries (LMICs). Chronic diseases have a tendency to occur simultaneously and where there are two or more such conditions, this is termed as ‘multimorbidity’. Multimorbidity is associated with adverse health outcomes, but limited research has been undertaken in LMICs. Therefore, this study examines the prevalence and correlates of multimorbidity as well as the associations between multimorbidity and self-rated health, activities of daily living (ADLs), quality of life, and depression across six LMICs. Methods Data was obtained from the WHO’s Study on global AGEing and adult health (SAGE) Wave-1 (2007/10). This was a cross-sectional population based survey performed in LMICs, namely China, Ghana, India, Mexico, Russia, and South Africa, including 42,236 adults aged 18 years and older. Multimorbidity was measured as the simultaneous presence of two or more of eight chronic conditions including angina pectoris, arthritis, asthma, chronic lung disease, diabetes mellitus, hypertension, stroke, and vision impairment. Associations with four health outcomes were examined, namely ADL limitation, self-rated health, depression, and a quality of life index. Random-intercept multilevel regression models were used on pooled data from the six countries. Results The prevalence of morbidity and multimorbidity was 54.2 % and 21.9 %, respectively, in the pooled sample of six countries. Russia had the highest prevalence of multimorbidity (34.7 %) whereas China had the lowest (20.3 %). The likelihood of multimorbidity was higher in older age groups and was lower in those with higher socioeconomic status. In the pooled sample, the prevalence of 1+ ADL limitation was 14 %, depression 5.7 %, self-rated poor health 11.6 %, and mean quality of life score was 54.4. Substantial cross-country variations were seen in the four health outcome measures. The prevalence of 1+ ADL limitation, poor self-rated health, and depression increased whereas quality of life declined markedly with an increase in number of diseases. Conclusions Findings highlight the challenge of multimorbidity in LMICs, particularly among the lower socioeconomic groups, and the pressing need for reorientation of health care resources considering the distribution of multimorbidity and its adverse effect on health outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s12916-015-0402-8) contains supplementary material, which is available to authorized users.

0 comments Cited 173 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice

Christopher Harrison, Helena Britt, Graeme Miller … (2014)

Objectives Prevalence estimates of multimorbidity vary widely due to inconsistent definitions and measurement methods. This study examines the independent effects on prevalence estimates of how ‘disease entity’ is defined—as a single chronic condition or chapters/domains in the International Classification of Primary Care (V.2; ICPC-2), International Classification of Disease (10th revision; ICD-10) or the Cumulative Illness Rating Scale (CIRS), the number of disease entities required for multimorbidity, and the number of chronic conditions studied. Design National prospective cross-sectional study. Setting Australian general practice. Participants 8707 random consenting deidentified patient encounters with 290 randomly selected general practitioners. Main outcome measures Prevalence estimates of multimorbidity using different definitions. Results Data classified to ICPC-2 chapters, ICD-10 chapters or CIRS domains produce similar multimorbidity prevalence estimates. When multimorbidity was defined as two or more (2+) disease entities: counting individual chronic conditions and groups of chronic conditions produced similar estimates; the 12 most prevalent chronic conditions identified about 80% of those identified using all chronic conditions. When multimorbidity was defined as 3+ disease entities: counting individual chronic conditions produced significantly higher estimates than counting groups of chronic conditions; the 12 most prevalent chronic conditions identified only two-thirds of patients identified using all chronic conditions. Conclusions Multimorbidity defined as 2+ disease entities can be measured using different definitions of disease entity with as few as 12 prevalent chronic conditions, but lacks specificity to be useful, especially in older people. Multimorbidity, defined as 3+, requires more measurement conformity and inclusion of all chronic conditions, but provides greater specificity than the 2+ definition. The proposed concept of “complex multimorbidity”, the co-occurrence of three or more chronic conditions affecting three or more different body systems within one person without defining an index chronic condition, may be useful in identifying high-need individuals.

0 comments Cited 147 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Andrea Icks: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 6 April 2017

Publication date Collection: 2017

Volume: 12

Issue: 4

Electronic Location Identifier: e0174322

Affiliations

[1 ]Collective Health Program, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brasil

[2 ]Division of Population Research, Brazilian National Cancer Institute, Rio de Janeiro, Brasil

Heinrich-Heine-Universitat Dusseldorf Medizinische Fakultat, GERMANY

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceptualization: JC DS.
Data curation: JC DS.
Formal analysis: JC DS MC AR.
Funding acquisition: DS.
Investigation: JC DS MC.
Methodology: JC DS.
Project administration: JC DS.
Resources: JC DS.
Software: JC DS MC AR.
Supervision: DS.
Validation: DS AR MC.
Visualization: JC.
Writing – original draft: JC.
Writing – review & editing: DS MC AR.

[¤]

Current address: Universidade Federal do Rio Grande do Norte / Federal University of Rio Grande do Norte. Programa de Pós-Graduação em Saúde Coletiva / Graduate Program in Collective Health. Avenida Senador Salgado Filho, Lagoa Nova, Natal-RN, Brasil.

* E-mail: janusenogueira@ 123456hotmail.com

Author information

Januse Nogueira de Carvalho http://orcid.org/0000-0001-5204-7116

Article

Publisher ID: PONE-D-16-42344

DOI: 10.1371/journal.pone.0174322

PMC ID: 5383049

PubMed ID: 28384178

SO-VID: 02b5d1e7-ac5f-4a4f-a684-07ec4f0bb309

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 24 October 2016

Date accepted : 7 March 2017

Page count

Figures: 1, Tables: 5, Pages: 13

Funding

The authors received no specific funding for this work.

Custom metadata

Data Availability Data are from the study “National Health Survey”, and are available to public consult on: http://www.ibge.gov.br/home/estatistica/populacao/pns/2013/default_xls.shtm.

Prevalence of multimorbidity in the Brazilian adult population according to socioeconomic and demographic characteristics

Read this article at

Abstract

Related collections

PLOS Climate

Most cited references 24

Multimorbidity in older adults.

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?

Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice

Author and article information

Contributors

Journal

Affiliations

Author notes

Author information

Article

History

Page count

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 119

Cited by 47

Most referenced authors 590