The European General Practice Research Network Presents the Translations of Its Comprehensive Definition of Multimorbidity in Family Medicine in Ten European Languages

Reste, Jean Yves Le; Nabbe, Patrice; Rivet, Charles; Lygidakis, Charilaos; Doerr, Christa; Czachowski, Sławomir; Lingner, Heidrun; Argyriadou, Stella; Lazić, Đurđica Kašuba; Assenova, Radost; Hasaganic, Melida; Munoz, Miquel; Thulesius, Hans; Floch, Bernard Le; Derriennic, Jeremy; Sowinska, Agnieska; Marwijk, Harm van; Liétard, Claire; Royen, Paul Van

doi:10.1371/journal.pone.0115796

Cited by 49 publications

(55 citation statements)

References 36 publications

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“…[17,23,24,38,39,40] Second, our study focuses on hospitalized elderly multimorbidity patients requiring complex health care, and their definition is not universally accepted. Currently, multimorbidity is defined as the presence of two or more chronic diseases in the same subject or the combination of one chronic illness with at least one other disease (acute or chronic) or bio-psychosocial factor [41]. This definition is too broad and fails to capture the complexity of some populations.…”

Section: Discussionmentioning

confidence: 99%

Multimorbidity gender patterns in hospitalized elderly patients

et al. 2020

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Patients with multimorbidity and complex health care needs are usually vulnerable elders with several concomitant advanced chronic diseases. Our research aim was to evaluate differences in patterns of multimorbidity by gender in this population and their possible prognostic implications, measured as in-hospital mortality, 1-month readmissions, and 1-year mortality. We focused on a cohort of elderly patients with well-established multimorbidity criteria admitted to a specific unit for chronic complex-care patients. Multimorbidity criteria, the Charlson, PROFUND and Barthel indexes, and the Pfeiffer test were collected prospectively during their stays. A total of 843 patients (49.2% men) were included, with a median age of 84 [interquartile range (IQR) 79-89] years. The women were older, with greater functional dependence [Barthel index: 40 (IQR:10-65) vs. 60 (IQR: 25-90)], showed more cognitive deterioration [Pfeiffer test: 5 (IQR:1-9) vs. 1 (0-6)], and had worse scores on the PROFUND index [15 (IQR:9-18) vs. 11.5 (IQR: 6-15)], all p <0.0001, while men had greater comorbidity measured with the Charlson index [5 (IQR: 3-7) vs. 4 (IQR: 3-6); p = 0.002]. In the multimorbidity criteria scale, heart failure, autoimmune diseases, dementia, and osteoarticular diseases were more frequent in women, while ischemic heart disease, chronic respiratory diseases, and neoplasms predominated in men. In the analysis of grouped patterns, neurological and osteoarticular diseases were more frequent in females, while respiratory and cancer predominated in males. We did not find gender differences for in-hospital mortality, 1-month readmissions, or 1-year mortality. In the multivariate analysis age, the Charlson, Barthel and PROFUND indexes, along with previous admissions, were independent predictors of 1-year mortality, while gender was non-significant. The Charlson and PROFUND indexes predicted mortality during follow-up more accurately in men than in women (AUC 0.70 vs. 0.57 and 0.74 vs. 0.62, respectively), with both p<0.001. In conclusion, our study shows differing patterns of multimorbidity by gender, with greater functional impairment in women and more comorbidity in men, although without differences in the prognosis. Moreover, some of these prognostic indicators had differing accuracy for the genders in predicting mortality.

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Section: Discussionmentioning

confidence: 99%

Multimorbidity gender patterns in hospitalized elderly patients

et al. 2020

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“…1 This definition is relevant for the health of patients with long-term conditions, including patients with multimorbidity. 2 However, the burden of self-care is considerable for these patients, [3][4][5][6] and if they are to live well, self-manage and thus be 'healthy', they need more support than health professionals alone can provide. [7][8][9] Social support networks are essential for people living with long-term conditions.…”

Section: Introductionmentioning

confidence: 99%

General practice and patients’ views of the social networks of patients with multimorbidity

2018

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INTRODUCTION For patients with multimorbidity to live well, they need the support of not only health professionals but family, friends and organisations. These social networks provide support, potentially enabling the formation of a Community of Clinical Practice approach to multimorbidity care. AIM This study aimed to explore general practice knowledge of the social networks of patients with multimorbidity. METHODS Social network maps were completed by both patients and general practice. The social network maps of 22 patients with multimorbidity were compared with corresponding social network maps completed by general practice staff. RESULTS In 60% (13/22) of the patients, general practice staff held a high or moderate knowledge of individual patients’ social networks. Information on social networks was recalled from staff memory and not systematically recorded in patients’ electronic health records. DISCUSSION Social network information is not routinely collected, recorded or used by general practice to understand the support available to patients with multimorbidity. General practice could take an active role in coordinating social network supporters for certain patient groups with complex multimorbidity. For these groups, there is value in systematically recording and regularly updating their social network information for general practice to use as part of a coordinated Community of Clinical Practice.

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“…[17] To assess this for GPs in different European countries, the enhanced definition of multimorbidity was carefully translated into 10 European languages using a Delphi consensus methodology from a previous work. [18] It was then necessary to present the translated definitions to practicing GPs to check if they recognize the developed concept of multimorbidity. The current survey was designed to answer the following question: Do European GPs recognize the enhanced concept of multimorbidity, and would they want to change it?…”

Section: Introductionmentioning

confidence: 99%