Prevalence, impact and cost of multimorbidity in a cohort of people with chronic pain in Ireland: a study protocol

Slattery, Brian; O’Connor, Laura; Haugh, Stephanie; Dwyer, Christopher P.; O’Higgins, Siobhán; Caes, Line; Egan, Jonathan; McGuire, Brian E.

doi:10.1136/bmjopen-2016-012131

Cited by 4 publications

(2 citation statements)

References 34 publications

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“…Due to their slow progression and long period of treatment, they produce negative effects on an individual's physical, emotional, and mental wellbeing, frequently leading to ill health and mortality [4,5]. The population of Ireland is ageing rapidly, with a high number of people older than 50 suffering from multimorbidity [6][7][8]. The prevalence of chronic conditions among the adult population in Ireland is increasing [9,10].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic coding of chronic physical conditions in Irish general practice

Pericin¹,

Larkin²,

Collins³

2021

Ir J Med Sci

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Background Chronic conditions are responsible for significant mortality and morbidity among the population in Ireland. It is estimated that almost one million people are affected by one of the four main categories of chronic disease (cardiovascular disease, chronic obstructive pulmonary disease, asthma, and diabetes). Primary healthcare is an essential cornerstone for individuals, families, and the community and, as such, should play a central role in all aspects of chronic disease management. Aim The aim of the project was to examine the extent of chronic disease coding of four chronic physical conditions in the general practice setting. Methods The design was a descriptive cross-sectional study with anonymous retrospective data extracted from practices. Results Overall, 8.8% of the adult population in the six participating practices were coded with at least one chronic condition. Only 0.7% of adult patients were coded with asthma, 0.3% with COPD, 3% with diabetes, and 3.3% with CVD. Male patients who visited their GP in the last year were more likely to be coded with any of the four chronic diseases in comparison with female patients. A significant relationship between gender and being coded with diabetes and CVD was found. Conclusions For a likely multitude of reasons, diagnostic coding in Irish general practice clinics in this study is low and insufficient for an accurate estimation of chronic disease prevalence. Monitoring of information provided through diagnostic coding is important for patients’ care and safety, and therefore appropriate training and reimbursement for these services is essential.

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Section: Introductionmentioning

confidence: 99%

Diagnostic coding of chronic physical conditions in Irish general practice

Pericin¹,

Larkin²,

Collins³

2021

Ir J Med Sci

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“…Concerning pain, there are consistent data showing that a majority of multimorbid elderly patients suffer from pain, mostly low back pain. 25 – 27 Consequently, better addressing chronic pain in a multifaceted way should be emphasized in pre- and postgraduate training of physicians for improving multimorbid patients’ quality of life, patient satisfaction, adherence to treatment and disease outcomes. 5 – 7 …”

Section: Discussionmentioning

confidence: 99%

Patient-provider concordance in the perception of illness and disease: a cross-sectional study among multimorbid patients and their general practitioners in Switzerland

Neuner-Jehle¹,

Zechmann²,

Maissen³

et al. 2017

PPA

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BackgroundMultiple chronic health conditions are leading to multiple treatment procedures and polypharmacy. Prioritizing treatment according to patients’ needs and preferences may be helpful for deprescribing. Thus, for improving health care, it is crucial for general practitioners (GPs) to perceive the chief complaints (CCs) of patients. The primary aim of this study was to investigate the patient–provider concordance of CCs and the secondary aim was to investigate the concordance between CCs and diagnosis, in a sample of Swiss multimorbid patients.Materials and methodsA cross-sectional analysis based on a cluster randomized controlled trial (RCT) among 46 GPs, recruited between March 2015 to July 2016, and 334 multimorbid patients (≥60 years taking ≥5 drugs for at least 6 months) in Northern Switzerland was performed. CCs listed by GPs and by patients (n=128) were classified according to the International Classification of Primary Care, version 2 (ICPC-2) coding system on chapter and component level and defined as concordant if ICPC-2 codes of patients and GPs were identical. Concordance was classified into full, moderate or low, depending on the ranking of patients’ CCs on GPs’ list. As secondary outcome, we compared patients’ CCs to GPs’ diagnosis. Statistics included descriptive measures and a multivariate regression analysis of factors that are modifying concordance.ResultsThe mean age of patients was 76.9 (SD 8.1) years, where 38% were male, taking 7.9 (SD 2.6) drugs on the long term. The most frequent complaint was pain. Concordance of the CC was given in 101/128 (78.9%) on the ICPC-2 chapter level, whereby 86/128 (67.2%) showed full, 8/128 (6.3%) moderate and 7/128 (5.5%) low concordance; 27/128 (21.1%) were discordant. Concordance between CCs and diagnosis was 53.6%. Concordance increased with the intensity of the CC rated by patients (OR 1.48, CI 1.13–1.94, P<0.001). The younger age and higher intake of drugs were significantly associated with an increased concordance between CCs and diagnosis.ConclusionA majority of GPs perceive the CCs of the multimorbid patients correctly, but there is room for improvement.

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