Abstracting and Indexing

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Introduction: Living with two or more chronic illnesses, known as multimorbidity, is an increasingly common challenge, especially in low- and middle-income countries such as India. Rural primary-care systems often struggle with fragmented referrals, scarce resources and a lack of unified guidelines, all of which complicate day-to-day management. This reviewd examines the prevalence, clinical patterns and health-system impact of multimorbidity within primary care. Insights from Katihar Medical College are used to highlight practical strategies for comprehensive, patient-centred management.

Methods: A twelve-month retrospective audit of electronic and paper records was undertaken at Katihar Medical College. Adults aged 18 years or older with at least two documented chronic conditions were included. Quantitative data were supplemented by thematic analysis of semi-structured interviews with primary-care physicians.

Results: Among 436 eligible patients, the most common disease pairings were hypertension with type 2 diabetes and chronic obstructive pulmonary disease with ischaemic heart disease. Polypharmacy was widespread (64.7 %), and nearly half the cohort (43.8 %) showed poor adherence to medication regimens. Physicians cited gender inequities, limited access to care and insufficient counselling services as major impediments to disease control and service utilisation.

Conclusion: Managing multimorbidity effectively requires a shift from single-disease protocols to integrated, patient-focused models of care. Strengthening coordinated care networks, enhancing primarycare training and improving patient engagement are crucial steps toward better outcomes and greater system efficiency in settings like Katihar.