Multimorbidity, polypharmacy and the clinical profile of adults attending a rural primary care hospital: a retrospective cross-sectional study

Abstract

Background: Multimorbidity is an increasing challenge in primary care, particularly in rural settings. This study characterized the clinical profile of adults attending a rural primary care hospital and assessed the prevalence of multimorbidity and polypharmacy.

Methods: A retrospective cross-sectional study was conducted using outpatient records generated from January 2023 to December 2025 at St. Francis Hospital, Khatauli, Uttar Pradesh. Adults attending for the first time during the study period with documented blood pressure and at least one of random blood glucose or hemoglobin were included. Sociodemographic characteristics, clinical measurements, diagnoses, medication burden, tobacco and alcohol use were extracted. Binary logistic regression was used to identify factors associated with multimorbidity.

Results: Among 304 participants, the mean age was 47.07±17.70 years and 69.1% were female. Hypertension, diabetes mellitus and anemia were present in 39.6%, 31.6% and 61.5%, respectively. Polypharmacy was present in 9.9%. Participants aged ≥60 years had higher odds of multimorbidity than those aged <60 years (adjusted odds ratio 1.87, 95% confidence interval 1.03-3.40; p=0.040). Polypharmacy was associated with increased odds of multimorbidity, although the adjusted association was not statistically significant (adjusted odds ratio 2.31, 95% confidence interval 0.92-5.81; p=0.076).

Conclusions: Multimorbidity was common among adults attending this setting. The findings support integrated chronic disease management, routine assessment of multimorbidity, and periodic medication review in rural primary care.