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Review
. 2019 Aug 22:9:2235042X19870934.
doi: 10.1177/2235042X19870934. eCollection 2019 Jan-Dec.

Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies

Hai Nguyen  1 , Gergana Manolova  1 , Christina Daskalopoulou  1 , Silia Vitoratou  1 , Martin Prince  1 , A Matthew Prina  1
Affiliations
Review

Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies

Hai Nguyen et al. J Comorb. .

Abstract

Background: With ageing world populations, multimorbidity (presence of two or more chronic diseases in the same individual) becomes a major concern in public health. Although multimorbidity is associated with age, its prevalence varies. This systematic review aimed to summarise and meta-analyse the prevalence of multimorbidity in high, low- and middle-income countries (HICs and LMICs).

Methods: Studies were identified by searching electronic databases (Medline, Embase, PsycINFO, Global Health, Web of Science and Cochrane Library). The term 'multimorbidity' and its various spellings were used, alongside 'prevalence' or 'epidemiology'. Quality assessment employed the Newcastle-Ottawa scale. Overall and stratified analyses according to multimorbidity operational definitions, HICs/LMICs status, gender and age were performed. A random-effects model for meta-analysis was used.

Results: Seventy community-based studies (conducted in 18 HICs and 31 LMICs) were included in the final sample. Sample sizes ranged from 264 to 162,464. The overall pooled prevalence of multimorbidity was 33.1% (95% confidence interval (CI): 30.0-36.3%). There was a considerable difference in the pooled estimates between HICs and LMICs, with prevalence being 37.9% (95% CI: 32.5-43.4%) and 29.7% (26.4-33.0%), respectively. Heterogeneity across studies was high for both overall and stratified analyses (I 2 > 99%). A sensitivity analysis showed that none of the reviewed studies skewed the overall pooled estimates.

Conclusion: A large proportion of the global population, especially those aged 65+, is affected by multimorbidity. To allow accurate estimations of disease burden, and effective disease management and resources distribution, a standardised operationalisation of multimorbidity is needed.

Keywords: HICs; LMICs; Multimorbidity; prevalence.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram of studies selection.
Figure 2.
Figure 2.
Age- and sex-specific prevalence of multimorbidity.
Figure 3.
Figure 3.
(a) Forest plot showing multimorbidity prevalence in HICs. (b) Forest plot showing multimorbidity prevalence in LMICs. HIC: high-income country; LMIC: low-income country.
See this image and copyright information in PMC

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