Concurrent Chronic Conditions in Adult Patients of the Medical Out-Patient Clinic of the Tema General Hospital

Abstract

Chronic conditions are a significant source of disease burden in Ghana including The Tema General Hospital (TGH). When concurrent in an individual, the outcomes are poorer. Yet medical research, preventive and clinical services are focused on single disease entities. The few studies conducted have predominantly been in developed countries and the elderly. This research determined the prevalence, distribution and socio-demographic risk factors of concurrent chronic conditions in our setting, to inform appropriate prevention and clinical care planning and practices. A cross-sectional study was conducted in adult patients of the medical clinic of the main OPD of TGH from 21 st May to 8 th June 2012. Consecutive patients were sampled and interviewed using a structured questionnaire to collect data on socio- demographic characteristics and medical history. Medical diagnoses were extracted from the medical records. Concurrent chronic condition was defined as the presence of two or more of 13 pre-selected conditions in an individual, and its association with a range of socio-demographic characteristics was determined using multivariate logistic regression. Of the 1,399 records analysed, 38.8% (95% CI: 36.3 – 41.4) had concurrent chronic conditions. As much as 48.6% of the persons with concurrent chronic conditions were young adults (18-59 years). The most common combination of conditions was diabetes mellitus and hypertension. Age, sex and a family history of chronic condition were independently associated with concurrent chronic conditions. Of these, age was the most significant; compared with the referent age group of 18 – 39 years, the adjusted odds for people aged 60 years and above was higher (OR =15.82 ,95% CI:10.66- 23.48, p <0.0001). Notably, the increasing prevalence observed with increasing age plateaus at a prevalence of about 60% by age 57 years. This study shows that concurrent chronic conditions are common in adult attendants of the medical clinic of the main OPD of the TGH. The most common combination was the pair of hypertension-diabetes mellitus and confirmed increasing age, female sex and a family history of a chronic condition as independent risk factors for concurrent chronic conditions. These prompt the need for research, medical education, prevention and clinical care plans on concurrent chronic conditions.