Development and Validation of a Questionnaire to Assess Multimorbidity in Primary Care: An Indian Experience

Sanghamitra Pati*, Mohammad Akhtar Hussain, Subhashisa Swain, Chris Salisbury, Job F. M. Metsemakers, J. Andre Knottnerus, Marjan van den Akker

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Multimorbidity remains an underexplored domain in Indian primary care. We undertook a study to assess the prevalence, correlates, and outcomes of multimorbidity in primary care settings in India. This paper describes the process of development and validation of our data collection tool "Multimorbidity Assessment Questionnaire for Primary Care (MAQ-PC)." An iterative process comprising desk review, chart review, and expert consultations was undertaken to generate the questionnaire. The MAQ-PC contained items on chronic conditions, health care utilization, health related quality of life, disease severity, and sociodemographics. It was first tested with twelve adults for comprehensibility followed by test-retest reliability with 103 patients from four primary care practices. For interrater reliability, two interviewers separately administered the questionnaire to sixteen patients. MAQ-PC displayed strong internal consistency (Cronbach's alpha: 0.69), interrater reliability (Cohen's Kappa: 0.78-1), and test-retest reliability (ICC: 0.970-0.741). Substantial concordance between self-report and physician diagnosis (Scott Kappa: 0.59-1.0) was observed for listed chronic conditions indicating strong concurrent validity. Nearly 54% had one chronic condition and 23.3% had multimorbidity. Our findings demonstrate MAQ-PC to be a valid and reliable measure of multimorbidity in primary care practice and suggest its potential utility in multimorbidity research in India.
Original languageEnglish
Article number6582487
Number of pages9
JournalBioMed Research International
Publication statusPublished - 2016


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