Sociodemographic determinants of multimorbidity in asthma: Insights from a retrospective cross-sectional study of the Obstructive Lung Disease program, Pakistan

Abstract

Background & Objective: Multimorbidity (MM) or the presence of additional chronic conditions in asthma, worsens disease control and increases healthcare use, but its prevalence and sociodemographic links in Pakistan are unclear. Our objectives were to assess the prevalence and patterns of MM in asthma and examine associations with key social and demographic factors.

Methodology: This observational cross sectional retrospective study was carried out at nine primary care sites of Indus Hospital & Health Network (IHHN), Pakistan. Obstructive Lung Disease (OLD) program data from January 2021 to March, 2025 of 5,802 physician confirmed asthma patients aged 12 years and above were analyzed using Statistical Package for Social Sciences (SPSS). Frequencies, percentages and logistic regression assessed prevalence, patterns, and associations of MM with age, gender, location, employment in asthma.

Results: Amongst 5,802 patients, 19% had MM, most commonly hypertension and diabetes mellitus. Prevalence was highest in middle-aged (22.5%) and older adults (31.2%), while 6.2% of adolescents and young adults were also affected. After adjusting for age, gender, geographical location, and employment status, the odds of having MM were significantly higher among middle-aged and older adults compared with adolescents and young adults (p < 0.001). Male sex, rural residence, and non-employment were also associated with MM (p < 0.05). Having >1 comorbidity was more likely in older (AOR = 15.72) and middle-aged (AOR = 9.63) adults than in younger groups, and in females versus males (AOR = 1.85; all p < 0.001).

Conclusion: Asthma patients in Pakistan face a substantial MM burden influenced by sociodemographic factors, highlighting the need for patient-centered care.