Multimorbidity in younger deprived patients: An exploratory study of research and service implications in general practice
Open Access
- 28 January 2008
- journal article
- Published by Springer Science and Business Media LLC in BMC Family Practice
- Vol. 9 (1), 1-5
- https://doi.org/10.1186/1471-2296-9-6
Abstract
Multimorbidity has been defined as the co-existence of two or more chronic conditions. It has a profound impact on both the individuals affected and on their use of healthcare services. The limited research to date has focused on its epidemiology rather than the development of interventions to improve outcomes in multimorbidity patients, particularly for patients aged less than 65 years. Potential barriers to such research relate to methods of disease recording and coding and examination of the process of care. We aimed to assess the feasibility of identifying younger individuals with multimorbidity at general practice level and to explore the effect of multimorbidity on the type and volume of health care delivered. We also describe the barriers encountered in attempting to carry out this exploratory research. Cross sectional survey of GP records in two large urban general practices in Dublin focusing on poorer individuals with at least three chronic conditions and aged between 45 and 64 years. 92 patients with multimorbidity were identified. The median number of conditions was 4 per patient. Individuals received a mean number of 7.5 medications and attended a mean number of GP visits of 11.3 in the 12 months preceding the survey. Barriers to research into multimorbidity at practice level were identified including difficulties relating to GP clinical software; variation in disease coding; assessment of specialist sector activity through the GP-specialist communications and assessment of the full scale of primary care activity in relation to other disciplines and other types of GP contacts such as home visits and telephone contacts. This study highlights the importance of multimorbidity in general practice and indicates that it is feasible to identify younger patients with multimorbidity through their GP records. This is a first step towards planning a clinical intervention to improve outcomes for such patients in primary care.Keywords
This publication has 12 references indexed in Scilit:
- Relationship between Number of Medical Conditions and Quality of CareNew England Journal of Medicine, 2007
- Multimorbidity's many challengesBMJ, 2007
- Interventions to improve outcomes in patients with multimorbidity in primary care and community settingsPublished by Wiley ,2007
- Chronic diseases: what happens when they come in multiples?2007
- Comparative assessment of three different indices of multimorbidity for studies on health-related quality of lifeHealth and Quality of Life Outcomes, 2005
- Cumulative Illness Rating Scale was a reliable and valid index in a family practice contextJournal of Clinical Epidemiology, 2005
- Prevalence of Multimorbidity Among Adults Seen in Family PracticeAnnals of Family Medicine, 2005
- Collaborative care needs and preferences of primary care patients with multimorbidityHealth Expectations, 2005
- Defining chronic conditions for primary care with ICPC-2Family Practice, 2004
- Multimorbidity and quality of life in primary care: a systematic reviewHealth and Quality of Life Outcomes, 2004