{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:35:20Z","timestamp":1787016920674,"version":"build-2736575974"},"reference-count":42,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"unspecified","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,7,13]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the prevalence, pattern and determinants of non-communicable diseases (NCDs) multimorbidity in Nepal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analysis of the data from the NCD survey 2018, which was conducted between 2016 and 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The data belong to the nationally representative survey, that selected the study samples from throughout Nepal using multistage cluster sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>8931 participants aged 20 years and older were included in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcomes<\/jats:title>\n                    <jats:p>NCD multimorbidity (occurrence of two or more chronic conditions including hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease and cancer). Descriptive statistics, prevalence ratio and odds ratio were computed to assess pattern and determinants of multimorbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean (SD) age was 46.7 years (14.9 years). The majority of the participants were women (57.8%), without formal education (53.4%) and from urban areas (51.5%). Multimorbidity was present in 13.96% (95% CI: 12.9% to 15.1%). Hypertension and diabetes coexisted in 5.7%. Age, alcohol consumption, body mass index, non-high-density lipoprotein (non-HDL) level and rural\u2013urban setting were significantly associated with multimorbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multimorbidity was prevalent in particular groups or geographical areas in Nepal suggesting a need for coordinated and integrated NCD care approach for the management of multiplicative co-comorbid conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-047665","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T11:34:01Z","timestamp":1627385641000},"page":"e047665","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Prevalence, pattern and determinants of chronic disease multimorbidity in Nepal: secondary analysis of a national survey"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-6306","authenticated-orcid":false,"given":"Raja Ram","family":"Dhungana","sequence":"first","affiliation":[{"name":"Nepal Family Development Foundation, Lalitpur, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khem Bahadur","family":"Karki","sequence":"additional","affiliation":[{"name":"Tribhuvan University Institute of Medicine, Maharajgunj, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bihungum","family":"Bista","sequence":"additional","affiliation":[{"name":"Nepal Health Research Council, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achyut Raj","family":"Pandey","sequence":"additional","affiliation":[{"name":"Abt Associates, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7176-7821","authenticated-orcid":false,"given":"Meghnath","family":"Dhimal","sequence":"additional","affiliation":[{"name":"Nepal Health Research Council, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh K","family":"Maskey","sequence":"additional","affiliation":[{"name":"Nepal Public Health Foundation, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,27]]},"reference":[{"key":"2025121602210867000_11.7.e047665.1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.5.1047"},{"key":"2025121602210867000_11.7.e047665.2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.15256\/joc.2017.7.91","article-title":"Multimorbidity: constellations of conditions across subgroups of midlife and older individuals, and related Medicare expenditures","volume":"7","author":"Koroukian","year":"2017","journal-title":"J Comorb"},{"key":"2025121602210867000_11.7.e047665.3","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp18X695465"},{"key":"2025121602210867000_11.7.e047665.4","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1363"},{"key":"2025121602210867000_11.7.e047665.5","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp11X548929"},{"key":"2025121602210867000_11.7.e047665.6","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-7-82"},{"key":"2025121602210867000_11.7.e047665.7","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glv128"},{"key":"2025121602210867000_11.7.e047665.8","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-1"},{"key":"2025121602210867000_11.7.e047665.9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0102149"},{"key":"2025121602210867000_11.7.e047665.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60240-2"},{"key":"2025121602210867000_11.7.e047665.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017264"},{"key":"2025121602210867000_11.7.e047665.12","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.20.2269"},{"key":"2025121602210867000_11.7.e047665.13","doi-asserted-by":"crossref","first-page":"87","DOI":"10.24095\/hpcdp.35.6.01","article-title":"Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada","volume":"35","author":"Roberts","year":"2015","journal-title":"Health Promot Chronic Dis Prev Can"},{"key":"2025121602210867000_11.7.e047665.14","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-1161"},{"key":"2025121602210867000_11.7.e047665.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2011.11.012"},{"key":"2025121602210867000_11.7.e047665.16","unstructured":"Alwan A . 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