Co-morbidity in general practice

Abstract

Background: Co-morbidity, or the presence of more than one clinical condition, is gaining increased attention in epidemiological and health services research. However, the clinical relevance of co-morbidity has yet to be defined. In general practice, few studies have been conducted into co-morbidity, either at a single health care encounter, an episode of care, or for a defined time period. Aims: To describe the major co-morbidity cluster profiles recorded by general practitioners. Another aim of this study is to describe the common clusters of co-prescribing. Methods and results: Twelve month data from patients attending 156 GPs from 95 practices around a six month period of January to June 2003 were analysed. This represented 840 961 encounters from about 200 000 individual patients at these participating practices. Co-morbidity and co-prescribing cluster profiles are represented by problems managed and reasons for prescribing for the top 10 presentations and top 10 prescribed drugs in the study period. Conclusions: By analysing the 10 most prevalent problems and 10 most prevalent drugs prescribed in consultations in a community sample, other co-morbidities that are particular to general practice, for example hypertension and lipid disorders, can be uncovered. Whether these clusters are causally related or occur by chance requires further analysis.

Polymorbidity in diabetes in older people: consequences for care and vocational training

“…Most studies on the occurrence of multiple chronic diseases are performed in general practices 14 17 18. Our findings of the common occurrence of polymorbidity are in accordance with these studies, and extend the previous findings to DNS and MS practices.…”

Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study

“…[3][4][5] Some studies have been based on surveys or administrative data, or have been restricted to older populations. 6,7 Most studies based on medical records have involved relatively small numbers of practices and/or patients, 3 while larger studies have focused on the determinants and prevalence of multimorbidity, [8][9][10][11][12] but few have related this to process or outcome variables in primary care. 13,14 Earlier research on multimorbidity has been limited by problems with case definition and with the reliability of data recording within routine practice records.…”

Changes in drug therapy following hospital discharge for patients in a general practice: a German incident study

“…Within the group of cardiovascular diseases, hypertension and hyperlipidemia are the most common disorders causing chronic drug usage (Katz et al 1996;Lau et al 1999;Harder S et al 1998;Saltman et al 2005). In our study, cardiovascuIar drugs were also the superior class of drugs that have been prescribed and changed during and after hospitalization.…”