Multimorbidity, polypharmacy and health seeking patterns among elderly living in Kalutara District, Sri Lanka

Introduction: Multimorbidity and polypharmacy are common among elderly. Yet, limited evidence is available on these issues and how elderly people seek health in a community setting in Sri Lanka.  
Objectives: To assess the prevalence of multimorbidity and polypharmacy and health seeking pattern among elderly aged 60-74 years living in the Kalutara District, Sri Lanka.
Methods: DA descriptive cross-sectional study was conducted. Multistage cluster sampling technique was applied and Grama Niladhari division (GND) was considered the cluster. Eligible participants were interviewed with a judgmentally validated questionnaire, and a data extraction sheet was used to obtain clinical data. A participant having two or more diseases at least for three months period was considered as having multimorbidity while a participant on five or more types of drugs per day was considered as polypharmacy. Continuous variables were described with mean and standard deviation (SD), while categorical variables were described using absolute numbers and percentages.  
Results: A total of 922 participants were interviewed (response rate of 94.1%) and the mean age was 66 years (SD=4.0). The prevalence of multimorbidity was 56.9% (95% confidence interval (CI): 53.7, 60.1). The prevalence of polypharmacy was 19.4% (95% CI: 16.9, 22.1). The majority of participants (n=503; 54.6%) sought health from state allopathic medical institutions, while 52.1% (n=480) of them identified doctors in state allopathic medical institutions as their main health information provider. Also, 42.9% (n=395) of elderly sought health information from general practitioners in private sector. 
Conclusions & Recommendations: More than half of the study sample and about one fifth of them had multimorbidity and polypharmacy, respectively. Majority of elderly rely on state health services to obtain both care and health related information. It is recommended to strengthen geriatric friendly health services in state sector health institutions and ensure coordination between state and private healthcare providers.