Prevalence and Social Determinants of Multiple Long-term Conditions among Adults of Odisha, India: A Population-based Cross-sectional Study

Multiple long-term conditions (MLTCs) defined as the co-occurrence of ≥2 chronic conditions are rising in low- and middle-income countries such as India. MLTCs can require continued medical support, investigations, and medications calling for health system strengthening. This highlights the need for assessing the burden of MLTC in the community. We estimated the prevalence of MLTCs and assessed their social determinants in Odisha, India. A cross-sectional study was conducted in two villages of Khordha district, Odisha, employing a systematic random sampling method. We recruited 530 adults aged ≥18 years between March and June 2023. Prevalence was presented as frequency and proportion, along with a 95% confidence interval (CI) as a measure of uncertainty. The relationship between MLTCs (≥2 conditions out of 28 assessed chronic conditions) and various sociodemographic traits - such as age, gender, education, and employment elicited using a validated Multimorbidity Assessment Questionnaire for Primary Care tool was examined through a multivariable logistic regression model. Results were expressed as adjusted odds ratios (AOR) with 95% CI. The overall prevalence of MLTCs was 29.21% (95% CI: 25.4-33.32). Individuals aged 60 years or older (AOR: 23.56 [95% CI: 7.55-73.53]), compared to those aged 18-30 years, and those residing in rural areas (AOR: 3.18 [95% CI: 1.70-5.92]), compared to their urban counterparts, were more likely to have MLTCs. Almost one-third of the adults had MLTCs that suggest an immediate need to develop, strengthen, and promote healthcare services for chronic conditions in the community that is accessible and cost-effective.