Patients with more comorbidities have better detection of chronic conditions, but poorer management and control: findings from six middle-income countries.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Chronic Disease/*epidemiology ; Chronic Disease/*prevention & control; Adolescent ; Adult ; Aged ; China/epidemiology ; Comorbidity ; Cross-Sectional Studies ; Female ; Ghana/epidemiology ; Humans ; India/epidemiology ; Male ; Mexico/epidemiology ; Middle Aged ; Russia/epidemiology ; South Africa/epidemiology ; Young Adult
    • Abstract:
      Background: The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comorbidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have important clinical implications as highlighted in the recent National Institute for Health and Care Excellence guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, untreated, and uncontrolled for NCDs, in 6 large MICs.
      Methods: Cross-sectional analysis of the World Health Organisation Study of Global Ageing and Adult Health (WHO SAGE) Wave 1 (2007-10), which consisted of adults aged ≥18 years from 6 populous MICs, including China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557).
      Results: A higher number of comorbidities was associated with better odds of diagnosis for hypertension, angina, and arthritis, and higher odds of having treatment for hypertension and angina. However, more comorbidities were associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina.
      Conclusion: Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Patients with multiple NCDs are high users of health services and are at an increased risk of adverse health outcomes. Hence, improving their access to care is a priority for healthcare systems.
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    • Contributed Indexing:
      Keywords: Access to care; Ageing; Chronic conditions; Comorbidity; Health monitoring; Non-communicable diseases
    • Publication Date:
      Date Created: 20200108 Date Completed: 20200318 Latest Revision: 20200318
    • Publication Date:
      20240105
    • Accession Number:
      PMC6945654
    • Accession Number:
      10.1186/s12889-019-8112-3
    • Accession Number:
      31906907