Measuring multimorbidity in family practice—a comparison of two methods

Prazeres, Filipe; Santiago, Luíz Miguel

doi:10.1093/fampra/cmy014

Cited by 9 publications

(9 citation statements)

References 18 publications

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“…Numa mesma população, a definição de multimorbilidade adotada e as doenças crónicas incluídas, influenciam os resultados obtidos. 23 Também a fonte de dados é variável, embora existam diversos estudos baseados em inquéritos populacionais, 20,21,24 muitos dos trabalhos nesta área têm como base registos clínicos. 4,6,7,10 Vários estudos mostram ainda a associação entre multimorbilidade e fatores socioeconómicos 25 : Os indivíduos que residem em áreas desfavorecidas apresentam-se com multimorbilidade 10 a 15 anos antes, quando comparados com os que habitam noutras zonas.…”

Section: Discussionunclassified

Multimorbilidade em Portugal: Dados do Primeiro Inquérito Nacional de Saúde com Exame Físico

Romana

Kislaya²,

Salvador³

et al. 2019

Acta Med Port

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Introduction: The simultaneous presence of multiple chronic diseases in the same individual is recognized as an important public health problem. Patients with multimorbidity have greater healthcare needs, which represents a higher burden on health services. Although there is no consensual definition of this concept, multimorbidity is usually defined as the presence of two or more chronic diseases in the same patient. The existence of evidence regarding multimorbidity will lead to more efficient management and treatment of these patients.Material and Methods: In order to estimate the prevalence of multimorbidity and to identify the associated factors, a cross-sectional epidemiological study was developed based on data from the INSEF, a population-based survey conducted on a representative probability sample of the Portuguese population (n = 4911). The prevalence of multimorbidity was estimated for the total population and separately for men and women, stratified by age group, region, education and income. The magnitudes of the associations were measured by the adjusted prevalence ratios calculated by the Poisson regression model.Results: Prevalence of multimorbidity was 38.3% (95% CI: 35.4% to 41.3%), with higher frequency in women, older people, Lisbon and Tagus Valley; Northern Portugal; Algarve and Alentejo regions and in those with lower academic qualifications. No association was found between multimorbidity and income.Discussion: Multimorbidity affects more than one third of the Portuguese population. Epidemiological data about multimorbidity in Portugal allows the identification of population groups with higher multimorbidity prevalence.Conclusion: Our results, which highlight the greater risk of multimorbidity among older and less instructed people, are in line with the literature. These results show the relevance of multimorbidity patients and are especially important in the way how healthcare is organized and provided.

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Section: Discussionunclassified

Multimorbilidade em Portugal: Dados do Primeiro Inquérito Nacional de Saúde com Exame Físico

Romana

Kislaya²,

Salvador³

et al. 2019

Acta Med Port

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“…This study collected information of the participants on gender, age, marital status, education level, health insurance, occupation, past history, BMI, smoking, alcohol consumption, admission diagnosis and discharge diagnosis according to the International Classification of Diseases (ICD-10) standards, disease counts, and other clinical and epidemiological characteristics as well as influencing factors for multimorbid condition. Based on the recommended definition in international multimorbidity studies ( 5 , 20 ), multimorbidity in the current study was defined and measured as the simultaneous occurrence of several chronic conditions in the same patient ( 21 ).…”

Section: Methodsmentioning

confidence: 99%

Multimorbidity in Hospitalized Patients Admitted to General Practice Departments and Its Implications for the General Practice Healthcare System: A Four-Year Longitudinal Study in China

Zhou

Shi

Liu

et al. 2021

Front. Public Health

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Objective: China and many developing countries has placed high expectations on the general practice healthcare system in terms of lowering medical costs and improving the health status of the multimorbid population in recent years. However, the prevalence of multimorbidity among inpatients attending the general practice department of hospitals and its policy implications are largely unknown. The current study aimed to analyze the prevalence of comorbidities among inpatients attending the general practice department of the tertiary Grade-A Hospitals in China, and put forward evidence-based policy recommendations.Methods: Between December 2016 and November 2020, 351 registered general practitioners from 27 tertiary hospitals were selected, and their direct admissions were evaluated. The rate and composition ratio were used for descriptive analysis of the clinical and epidemiological characteristics of multimorbidity. A backward stepwise algorithm was used to explore independent variables. The absence of multicollinearity and plausible interactions among variables were tested to ensure the robustness of the logistic regression model. The pyramid diagram was used to show the link between gender and the involved human body system in multimorbidity.Results: Multimorbidity was present in 93.1% of the 64, 395 patients who were admitted directly. Multimorbidity was significantly more prevalent in patients aged 45–59 years (OR=3.018, 95% CI=1.945–4.683), 60–74 years (OR = 4.349, 95% CI = 2.574–7.349), ≥75 years (OR = 7.804, 95% CI = 3.665–16.616), and those with body mass index (BMI) ≥ 28 kg/m2 (OR = 3.770, 95% CI = 1.453–9.785). The circulatory system was found to be the most commonly involved human body system in multimorbidity, accounting for 79.2% (95% CI = 78.8–79.5%) of all cases. Significant gender inequity was further observed in the involved human body system in multimorbidity.Conclusion: Multimorbidity is likely common among the inpatients attending the general practice department of hospitals in China and many developing countries, with significant gender inequity in the involved human body systems. Effective countermeasures include establishing a GP-PCIC multimorbidity prevention and control model and enhancing the multimorbidity of elderly and obese patients at both the clinical and healthy lifestyle levels. The diagnosis and treatment capabilities of GPs on the circulatory, endocrine, metabolic, digestive, and respiratory systems should be prioritized.

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“…Prazeres and Santiago reported a significant difference in the prevalence of multimorbidity in the same patient cohort using two different definitions. 11 Thus, a standardized definition of multimorbidity is required. In this study, CCI was used to express the number of diseases.…”

Section: Clinical Outcomementioning

confidence: 99%

Multimorbidity, polypharmacy, and mortality in older patients with pacemakers

Goto

Mori

Nakayama

et al. 2021

Journal of Arrhythmia

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Background:The prevalence of multimorbidity and polypharmacy and its association with all-cause mortality in older patients with pacemakers are largely unknown. We aimed to clarify the prevalence of multimorbidity and polypharmacy, and its association with all-cause mortality in patients ≥75 years of age with pacemakers. Methods:We retrospectively investigated 256 patients aged ≥75 years (mean age 84.0 ± 5.3 years; 45.7% male) with newly implanted pacemakers. The study endpoint was all-cause mortality ("with events"). Multimorbidity was defined as a Charlson Comorbidity Index ≥3. Polypharmacy was defined as the use of ≥5 medications. Results:During the follow-up period (median, 3.1 years), 60 all-cause deaths were reported. The Charlson Comorbidity Index (2.9 ± 1.9 vs. 1.7 ± 1.7, p < .001) and prevalence of multimorbidity (56.7% vs. 26.0%, p < .001) were significantly higher in deceased patients than in survivors. The number of drugs (6.9 ± 3.0 vs. 5.9 ± 3.3, p = .03) and the prevalence of polypharmacy (78.3% vs. 63.8%, p = .04) were significantly higher in patients with events than in those without events. The event-free survival rate was significantly higher among patients without multimorbidity than in those with multimorbidity (log-rank, p < .001), and was also significantly higher among patients without polypharmacy than in those with polypharmacy (log-rank, p < .001).

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Measuring multimorbidity in family practice—a comparison of two methods

Cited by 9 publications

References 18 publications

Multimorbilidade em Portugal: Dados do Primeiro Inquérito Nacional de Saúde com Exame Físico

Multimorbilidade em Portugal: Dados do Primeiro Inquérito Nacional de Saúde com Exame Físico

Multimorbidity in Hospitalized Patients Admitted to General Practice Departments and Its Implications for the General Practice Healthcare System: A Four-Year Longitudinal Study in China

Multimorbidity, polypharmacy, and mortality in older patients with pacemakers

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