Comorbidity versus multimorbidity: Why it matters

Harrison, Christopher; Fortin, Martin; Akker, Marjan van den; Mair, Frances S; Calderón‐Larrañaga, Amaia; Boland, Fiona; Wallace, Emma; Jani, Bhautesh; Smith, Susan M.

doi:10.1177/2633556521993993

Cited by 69 publications

(68 citation statements)

References 10 publications

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“…The ‘AND’ was used to the combination of search terms across the categories and ‘OR’ was combined within the categories. In addition, a term similar to the definition of multimorbidity is comorbidity, but in 2018, a distinction has been made between the definition of comorbidity and multimorbidity, and while both terms emphasize the co-existence of multiple chronic conditions in the same individual, the term of “comorbidity” means the combined effects of additional conditions with reference to the index chronic condition such as the comorbidity of diabetes, stroke, or depression [ 1 ]. Namely, comorbidity is the presence of one or more additional diseases, as a result of the presence of the index condition [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

“…Namely, comorbidity is the presence of one or more additional diseases, as a result of the presence of the index condition [ 19 ]. Although, these two terms have different definition, multimorbidity and comorbidity are commonly used interchangeably [ 1 , 8 ]. Thus, after the initial search, the addition of ‘comorbidity’ was added into our search to test if any articles had been missed through the exclusion of the term of ‘comorbidity’ and linguistic changes of the term of ‘comorbidity’ [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

“…Multimorbidity, also known as multiple chronic conditions, is generally defined as the presence of two or more chronic health conditions in a person at the same time [ 1 ]. Multimorbidity is more common in older adults (more than 60 years old), such as suffering from hypertension, diabetes and chronic kidney disease concurrently [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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The association between educational level and multimorbidity among adults in Southeast Asia: A systematic review

2021

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Background In Southeast Asia, the prevalence of multimorbidity is gradually increasing. This paper aimed to investigate the association between educational level and multimorbidity among over 15-years old adults in Southeast Asia. Methods We conducted a systematic review of published observational studies. Studies were selected according to eligibility criteria of addressing definition and prevalence of multimorbidity and associations between level of education and multimorbidity in Southeast Asia. The Newcastle-Ottawa Scale (NOS) was used to measure the quality and risk of bias. The methodology has been published in PROSPERO with registered number ID: CRD42021259311. Results Eighteen studies were included in the data synthesis. The results are presented using narrative synthesis due to the heterogeneity of differences in exposures, outcomes, and methodology. The prevalence of multimorbidity ranged from 1.7% to 72.6% among over 18 years-old adults and from 1.5% to 51.5% among older people (≥ 60 years). There were three association patterns linking between multimorbidity and education in these studies: (1) higher education reducing odds of multimorbidity, (2) higher education increasing odds of multimorbidity and (3) education having no association with multimorbidity. The association between educational attainment and multimorbidity also varies widely across countries. In Singapore, three cross-sectional studies showed that education had no association with multimorbidity among adults. However, in Indonesia, four cross-sectional studies found higher educated persons to have higher odds of multimorbidity among over 40-years-old persons. Conclusions Published studies have shown inconsistent associations between education and multimorbidity because of different national contexts and the lack of relevant research in the region concerned. Enhancing objective data collection such as physical examinations would be necessary for studies of the connection between multimorbidity and education. It can be hypothesised that more empirical research would reveal that a sound educational system can help people prevent multimorbidity.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The association between educational level and multimorbidity among adults in Southeast Asia: A systematic review

2021

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“…We decided to use the word polymorbidity to underline that the concurrent diseases could be chronic, short term or a sequalae to a primary disease. Multimorbidity is most often referred to the presence of multiple long‐term diseases, whereas comorbidity covers for sequalae or additional entities to a primary disease 17 …”

Section: Methodsmentioning

confidence: 99%

Polypharmacy in polymorbid pregnancies and the risk of congenital malformations—A systematic review

Thunbo

Vendelbo

Volqvartz

et al. 2021

Basic Clin Pharma Tox

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With an increased prevalence of concurrent morbidities during pregnancy, polypharmacy has become increasingly common in pregnant women. The risks associated with polypharmacy may exceed those of individual medication because of drug–drug interactions. This systematic review aims to evaluate the risk of congenital malformations in polymorbid pregnancies exposed to first‐trimester polypharmacy. PubMed, Embase and Scopus were searched to identify original human studies with first‐ trimester polypharmacy due to polymorbidity as the exposure and congenital malformations as the outcome. After screening of 4034 identified records, seven studies fulfilled the inclusion criteria. Four of the seven studies reported an increased risk of congenital malformations compared with unexposed or monotherapy, odds ratios ranging from 1.1 to >10.0. Particularly, short‐term anti‐infective treatment combined with other drugs and P‐glycoprotein substrates were associated with increased malformation risks. In conclusion, knowledge is limited on risks associated with first‐trimester polypharmacy due to polymorbidity with the underlying evidence of low quantity and quality. Therefore, an increased focus on pharmacovigilance to enable safe drug use in early pregnancy is needed. Large‐scale register‐based studies and better knowledge of placental biology are needed to support the clinical management of polymorbid pregnancies that require polypharmacy.

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“…Measurement of multimorbidity is useful for managing and assessing patients with chronic diseases because it addresses the patient as a whole in accordance with the patient-centered approach to care, as any intervention for a specific disease may impact other conditions. 5 Thus, reliable multimorbidity estimates are needed to inform public health officials, health policy makers and health economics assessors for appropriate resource allocation for the management and prevention of chronic diseases and their sequalae. In addition, adequate measures of multimorbidity may be used to adjust for overall general health of an individual in etiologic studies or to calculate propensity score that are subsequently used for this purpose.…”

Section: Introductionmentioning

confidence: 99%

Multimorbidity measures from health administrative data using ICD system codes: A systematic review

Simard

Rahme

Calfat

et al. 2021

Pharmacoepidemiology and Drug

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Background: We aimed to identify and characterize adult population-based multimorbidity measures using health administrative data and the International Classification of Diseases (ICD) codes for disease identification.Methods: We performed a narrative systematic review of studies using or describing development or validation of multimorbidity measures. We compared the number of diseases included in the measures, the process of data extraction (case definition) and the validation process. We assessed the methodological robustness using eight criteria, five based on general criteria for indicators (AIRE instrument) and three multimorbidity-specific criteria.Results: Twenty-two multimorbidity measures were identified. The number of diseases they included ranged from 5 to 84 (median = 20), with 19 measures including both physical and mental conditions. Diseases were identified using ICD codes extracted from inpatient and outpatient data (18/22) and sometimes including drug claims (10/22). The validation process relied mainly on the capacity of the measures to predict health outcome (5/22), or on the validation of each individual disease against a gold standard (8/22). Six multimorbidity measures met at least six of the eight robustness criteria assessed. Conclusion:There is significant heterogeneity among the measures used to assess multimorbidity in administrative databases, and about a third are of low to moderate quality. A more consensual approach to the number of diseases or groups of diseases included in multimorbidity measures may improve comparison between regions, and potentially provide better control for multimorbidity-related confounding in studies.

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Comorbidity versus multimorbidity: Why it matters

Cited by 69 publications

References 10 publications

The association between educational level and multimorbidity among adults in Southeast Asia: A systematic review

The association between educational level and multimorbidity among adults in Southeast Asia: A systematic review

Polypharmacy in polymorbid pregnancies and the risk of congenital malformations—A systematic review

Multimorbidity measures from health administrative data using ICD system codes: A systematic review

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