Multimorbidity

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Multimorbidity means living with two or more chronic illnesses.[1] For example, a person could have diabetes, heart disease and depression. Multimorbidity is common in older adults, estimated to affect over half of those aged 65 and over.[2] This increased prevalence has been explained by older adults' "longer exposure and increased vulnerability to risk factors for chronic health problems".[3] The prevalence of multimorbidity has been increasing in recent decades.[4][5][6] The high prevalence of multimorbidity has led to some describing it as "The most common chronic condition".[7] Multimorbidity is also more common among people from lower Socioeconomic statuses.[8][9][10] Multimorbidity is a significant issue in low‐ and middle‐income countries, though prevalence is not as high as in high income countries.[11]

Multimorbidity is associated with reduced quality of life[12] and increased risk of death.[13]

People with multimorbidity face many challenges because of the way health systems are organised. Most health systems are designed to cater for people with a single chronic condition.[14] Some of the difficulties experienced by people with multimorbidity include: poor coordination of medical care, managing multiple medications, high costs associated with treatment,[15] increases in their time spent managing illness,[16] difficulty managing multiple illness management regimes,[17] and aggravation of one condition by symptoms or treatment of another.[18]

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References[edit]

  1. ^ Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M. Defining comorbidity: implications for understanding health and health services. Ann Fam Med. 2009 Jul-Aug;7(4):357-63.
  2. ^ Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, Meinow B, Fratiglioni L. Aging with multimorbidity: a systematic review of the literature. Ageing research reviews. 2011 Sep 1;10(4):430-9.
  3. ^ Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, Meinow B, T Fratiglioni L. Aging with multimorbidity: a systematic review of the literature. Ageing research reviews. 2011 Sep 1;10(4):430-9.
  4. ^ King DE, Xiang J, Pilkerton CS. Multimorbidity trends in United States adults, 1988–2014. J Am Board Fam Med. 2018; 31(4): 503‐ 513.
  5. ^ Pefoyo AJK, Bronskill SE, Gruneir A, et al. The increasing burden and complexity of multimorbidity. BMC Public Health. 2015;15(1):415.
  6. ^ Uijen AA, van de Lisdonk EH. Multimorbidity in primary care: prevalence and trend over the last 20 years. Eur J Gen Pract. 2008;14(sup1):28‐32.
  7. ^ Tinetti ME, Fried TR, Boyd CM. Designing health care for the most common chronic condition—multimorbidity. Jama. 2012 Jun 20;307(23):2493-4.
  8. ^ Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, Meinow B, Fratiglioni L. Aging with multimorbidity: a systematic review of the literature. Ageing research reviews. 2011 Sep 1;10(4):430-9.
  9. ^ Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet. 2012 Jul 7;380(9836):37-43.
  10. ^ Pathirana TI, Jackson CA. Socioeconomic status and multimorbidity: a systematic review and meta‐analysis. Australian and New Zealand journal of public health. 2018 Apr;42(2):186-94.
  11. ^ Afshar S, Roderick PJ, Kowal P, Dimitrov BD, Hill AG. Multimorbidity and the inequalities of global ageing: a cross‐sectional study of 28 countries using the World Health Surveys. BMC Public Health. 2015;15(1):776.
  12. ^ Makovski TT, Schmitz S, Zeegers MP, Stranges S, van den Akker M. Multimorbidity and quality of life: systematic literature review and meta-analysis. Ageing research reviews. 2019 Aug 1;53:100903.
  13. ^ Nunes BP, Flores TR, Mielke GI, Thumé E, Facchini LA. Multimorbidity and mortality in older adults: a systematic review and meta-analysis. Archives of gerontology and geriatrics. 2016 Nov 1;67:130-8.
  14. ^ Salisbury C. Multimorbidity: redesigning health care for people who use it. Lancet. 2012;380(9836):7‐9.
  15. ^ Wang L, Si L, Cocker F, Palmer AJ, Sanderson K. A systematic review of cost‐of‐illness studies of multimorbidity. Appl Health Econ Health Policy. 2018;16(1):15‐29.
  16. ^ Jowsey T, McRae IS, Valderas JM, Dugdale P, Phillips R, Bunton R, Gillespie J, Banfield M, Jones L, Kljakovic M, Yen L (2013). "Time's up. descriptive epidemiology of multi-morbidity and time spent on health related activity by older Australians: a time use survey". PLOS ONE. 8 (4): e59379. Bibcode:2013PLoSO...859379J. doi:10.1371/journal.pone.0059379. PMC 3613388. PMID 23560046.
  17. ^ Jowsey T, Dennis S, Yen L, Mofizul Islam M, Parkinson A, Dawda P (July 2016). "Time to manage: patient strategies for coping with an absence of care coordination and continuity". Sociology of Health & Illness. 38 (6): 854–73. doi:10.1111/1467-9566.12404. PMID 26871716.
  18. ^ Bayliss EA, Steiner JF, Fernald DH, Crane LA, Main DS (2003). "Descriptions of barriers to self-care by persons with comorbid chronic diseases". Annals of Family Medicine. 1 (1): 15–21. doi:10.1370/afm.4. PMC 1466563. PMID 15043175.

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