Magnitude, pattern and correlates of multimorbidity among patients attending chronic outpatient medical care in Bahir Dar, northwest Ethiopia: the application of latent class analysis model

Eyowas, F. A.; Schneider, M.; Balcha, S. A.; Pati, S.; Getahun, F. A.

Objective This study aimed to investigate the magnitude, pattern and associated factors of multimorbidity in Bahir Dar, Ethiopia. Methods A multi-centered facility based study was conducted among 1440 participants aged 40+ years attending chronic outpatient medical care. Two complimentary methods (interview and review of medical records) were employed to collect the data on socio-demographic, behavioral and disease related characteristics. The data were analyzed by STATA V.16 and R Software V.4.1.0. We run descriptive statistics and fitted logistic regression and latent class analyses (LCA) models to determine associated factors and patterns of multimorbidity. Statistical significance was considered at p-value ,<=0.05. Results The magnitude of individual chronic conditions ranged from 1.4% to 37.9%, and multimorbidity was identified in 54.8% (95% CI=52.2%-57.4%) of the sample. The likelihood of developing multimorbidity was higher among participants aged from 45-54 years (AOR: 1.5, 95%CI= 1.1, 2.1), 55-64 years (AOR: 2.5, 95%CI=1.7, 3.5) and 65 years or more (AOR: 2.4, 95%CI=1.7, 3.5), among individuals classified as overweight (AOR: 1.6, 95%CI=1.2, 2.1) or obese (AOR: 1.9, 95%CI=1.3, 3.0) and among those individuals who believe in external locus of control (AOR: 1.8, 95%CI=1.3, 2.5). Four patterns of multimorbidity were identified, the cardiovascular category being the largest class (50.2%), followed by the metabolic group (32.6%). Advanced age, overweight and obesity predicted latent class membership, adjusting for relevant confounding factors. Conclusion The magnitude of multimorbidity in this study was high. The most frequently diagnosed chronic conditions shaped the patterns of multimorbidity. Advanced age, overweight and obesity were the factors profoundly associated with multimorbidity. Health service organization and provision in the study area need to be oriented by the realities in disease burden and pattern of multimorbidity. Further research is required to better understand the impact of multimorbidity on individuals well-being, survival and health service delivery.