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. 2015 Sep 21;105(8):642-7.
doi: 10.7196/samjnew.8794.

Multimorbidity, control and treatment of noncommunicable diseases among primary healthcare attenders in the Western Cape, South Africa

Naomi Folb  1 , Venessa Timmerman, Naomi S Levitt, Krisela Steyn, Max O Bachmann, Crick Lund, Eric D Bateman, Carl Lombard, Thomas A Gaziano, Merrick Zwarenstein, Lara R Fairall
Affiliations

Multimorbidity, control and treatment of noncommunicable diseases among primary healthcare attenders in the Western Cape, South Africa

Naomi Folb et al. S Afr Med J. .

Abstract

Background: South Africa (SA) is facing a heavy burden of non-communicable diseases (NCDs). Few studies address multimorbidity, control and treatment of NCDs in patients attending primary healthcare (PHC) clinics.

Objectives: To describe multimorbidity, related risk factors, disease severity and treatment status of patients with four important NCDs attending public sector PHC clinics in two districts in SA.

Methods: A cross-sectional sample of patients completed baseline data collection for a randomised controlled trial of a health systems intervention. The study population comprised adults attending PHC clinics in the Eden and Overberg districts of the Western Cape in 2011. Four subgroups of patients were identified: hypertension, diabetes, chronic respiratory disease and depression. A total of 4 393 participants enrolled from 38 clinics completed a baseline structured questionnaire and had measurements taken. Prescription data were recorded.

Results: Of participants with hypertension, diabetes, respiratory disease and depression, 80%, 92%, 88% and 80%, respectively, had at least one of the other three conditions. There were low levels of control and treatment: 59% of participants with hypertension had a blood pressure ≥140/90 mmHg, the mean haemoglobin A1c (HbA1c) value in participants with diabetes was 9%, 12% of participants in the depression group were prescribed an antidepressant at a therapeutic dose, and 48% of respiratory participants were prescribed a b2-agonist and 34% an inhaled corticosteroid.

Conclusion: Considerable multimorbidity and unmet treatment needs exist among patients with NCDs attending public sector PHC clinics. Improved strategies are required for diagnosing and managing NCDs in this sector.

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Figures

Fig. 1
Fig. 1
Venn diagram of multimorbidity associated with hypertension, diabetes, chronic respiratory disease and depression. (HPT = hypertension; DM = diabetes; CRD = chronic respiratory disease; DEP = depression.)
See this image and copyright information in PMC

Comment in

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