What do we mean by multimorbidity? An analysis of the literature on multimorbidity measures, associated factors, and impact on health services organization

Lefèvre, Thomas; d’Ivernois, Jean-François; Andrade, Vincent De; Crozet, Cyril; Lombrail, Pierre; Gagnayre, Rémi

doi:10.1016/j.respe.2014.09.002

Cited by 95 publications

(80 citation statements)

References 58 publications

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“…Our findings demonstrate significant gaps in multimorbidity research between HICs and LMICs with limited knowledge of etiology, epidemiology, patterns, progression, risk factors and efficacy and cost–effectiveness of different interventions [64,67]. Knowledge on polypharmacy is lacking, as most of the evidence generated from RCTs is of limited value to guide decisions about medication use by patients with multiple chronic diseases as the possible drug–to–drug, drug–to–disease, and disease–to–disease interactions remain unexamined [5].…”

Section: Discussionmentioning

confidence: 99%

Mapping the global research landscape and knowledge gaps on multimorbidity: a bibliometric study

Mishra

Jones

2017

Journal of Global Health

104

120

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BackgroundTo summarize global research trends and activities on multimorbidity; then to assess the knowledge gaps and to identify implications for knowledge exchange between high income countries (HICs) and low– and middle– income countries (LMICs).MethodsA comprehensive search was conducted to identify research publications on multimorbidity in the Web of ScienceTM, as well as diabetes, depression, hypertension, and Chronic Obstructive Pulmonary Disease (COPD). The time frame for the search was from 1900 to June, 2016. Information (such as publication date, subject category, author, country of origin, title, abstract, and keywords) were extracted and the full texts were obtained for the co–citation analysis. Data were linked with the life expectancy at birth (years) and Gross National Income (GNI). Co–citation and hierarchal clustering analysis was used to map the trends and research networks with CiteSpace II (JAVA freeware, copyright Chaomei Chen, http://cluster.cis.drexel.edu/~cchen/citespace/).FindingsWe identified 2864 relevant publications as at June 2016, with the first paper on this topic indexed in 1974 from Germany, but 80% were published after 2010. Further analysis yielded two knowledge gaps: (1) compared with single conditions (diabetes, hypertension, depression, and COPD), there is a mismatch between the high prevalence of multimorbidity and its research outputs (ratio of articles on multimorbidity vs other four single conditions is 1:13–150); (2) although a total of 76 countries have contributed to this research area, only 5% of research originated from LMICs where 73% of non–communicable disease (NCD) related deaths had occurred. Additional analysis showed the median year of first publication occurred 15 years later in the LMICs compared with HICs (2010 vs 1995); and longer life expectancy was associated with exponentially higher publication outputs (Pearson correlation coefficient r = 0.95) at the global level. The life expectancy at the median year (1994) of first publication was 66.1, with the gap between LMICs and HICs 7.9 (68.4 vs 76.3).ConclusionsThis study confirms substantial knowledge gaps in the research agenda on multimorbidity, with input urgently needed to move us forward worldwide, especially for and in LMICs. There is the possibility that LMICs can learn from and collaborate with HICs in this area.

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Section: Discussionmentioning

confidence: 99%

Mapping the global research landscape and knowledge gaps on multimorbidity: a bibliometric study

Mishra

Jones

2017

Journal of Global Health

104

120

View full text Add to dashboard Cite

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“…≥10% change in the coefficient). All analyses were performed on complete cases using STATA statistical software 12.0 [17]. …”

Section: Methodsmentioning

confidence: 99%

Work outcome in persons with musculoskeletal diseases: comparison with other chronic diseases & the role of musculoskeletal diseases in multimorbidity

Zee-Neuen

Putrik

Ramiro

et al. 2017

BMC Musculoskelet Disord

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BackgroundChronic diseases and multimorbidity are increasingly common among persons in working age. This study explores the impact of type, number and combinations of chronic diseases with focus on the role of MSKD on (1) adverse work status (i.e. work disability (WD), economic unemployment (UE) or receiving a living allowance (LA)) and on (2) the occurrence of sick leave.MethodsSubjects participating in a Dutch household survey, who were ≤65 years and could have paid work, provided data on socio-demographics and nine physician diagnosed chronic diseases. To explore the independent association of each chronic disease, of multimorbidity and of MSKD in context of multimorbidity with 1) work status (employed, WD, LA, UE) and 2) sick leave (SL) in those employed, multinomial logistic regressions and logistic regressions were used, respectively.ResultsAmong 5396 subjects, MSKD was the most common morbidity (17%), multimorbidity occurred in 755/5396 (14%), 436/755 (61%) of subjects with multimorbidity had an MSKD. For MSKD the odds of WD, LA and UE were 2.06 [95% CI 1.56;2.71], 2.15[1.18;3.91] and 1.35[0.94;1.96], respectively, compared to being employed and the odds of SL in MSKD were 2.29[1.92;2.73]. Mental diseases had a stronger impact on all these outcomes. The odds for adverse work outcomes increased strongly with an increasing number of diseases. When an MSKD was part of multimorbidity, an additional impact on the association with WD and SL was observed.ConclusionsMultimorbidity has a stronger impact on all work outcomes compared to single chronic diseases. The presence of the MSKD in the context of multimorbidity amplifies the chance of WD or SL.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1365-4) contains supplementary material, which is available to authorized users.

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“…Literature [3][4][5][6] considers multimorbidity the simultaneous occurrence of two or more morbidities, chronic physical or mental diseases in an individual. Individuals with multimorbidity, especially the elderly, tend to experience a greater number of hospitalizations, use multiple medications simultaneously and thereby increase their susceptibility to adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Multimorbidity associated with polypharmacy and negative self-perception of health

Cavalcanti

Doring

Portella

et al. 2017

Rev. bras. geriatr. gerontol.

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Objective: to verify the association between the multimorbidity of the elderly and sociodemographic variables, self-perception of health and polypharmacy. Method: a cross-sectional study was performed. The research data was collected using the Health, Well-Being and Aging questionnaire. The sample was composed of 676 people aged 60 years or more, who were residents of small towns in the north of the state of Rio Grande do Sul, Brazil. The dependent variable was multimorbidity, that is, the occurrence of two or more chronic non-communicable diseases in the same person. The independent variables were demographic, socioeconomic and health-related characteristics. Poisson's raw and robust regression model was used to analyze the effect of the independent variables in relation to the outcome and p was considered significant when <0.05. Result: among the elderly interviewed, 45% presented multimorbidity, 51.1% reported a selfperception of poor/very poor health and 37.1% used polypharmacy. After the analysis was adjusted to the occurrence of multimorbidity, association with the following variables was found: health perception (regular/poor/very poor) PR=1.15 (CI95%; 1.09 -1.22) and use of polypharmacy PR=1.29 (CI95%; 1.22 -1.35). Conclusion: Multimorbidity may interfere negatively in the self-perception of health of the elderly contributing to increased medicine consumption.

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What do we mean by multimorbidity? An analysis of the literature on multimorbidity measures, associated factors, and impact on health services organization

Cited by 95 publications

References 58 publications

Mapping the global research landscape and knowledge gaps on multimorbidity: a bibliometric study

Mapping the global research landscape and knowledge gaps on multimorbidity: a bibliometric study

Work outcome in persons with musculoskeletal diseases: comparison with other chronic diseases & the role of musculoskeletal diseases in multimorbidity

Multimorbidity associated with polypharmacy and negative self-perception of health

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