Multiple morbidities

Multiple morbidities or Multimorbidities means co-occurring diseases.[1] For example, a person could have diabetes and heart disease and high blood pressure. In the Medicare population, 65% of patients have two or more chronic illnesses.[2] Some of the difficulties experienced by patients include: poor coordination of medical care, managing multiple medications, increases in their time spent managing illness,[3] difficulty managing multiple illness management regimes,[4]> and aggravation of one condition by symptoms or treatment of another.[5] Concerning the qualitative experience of people with multimorbid chronic illness, Jowsey et al. (2009) write: "Co-morbidity increased the amount of time participants spent managing their health and increased patients' dependency on others. Patients with co-morbid conditions encountered problems with the coordination between services and with polypharmacy. Patients prioritised the management of one condition over another; consequently, some health issues could be neglected or compromised. The three most common challenges to patients and carers in managing chronic illness (either caused or made worse by co-morbidity), relate to acting on risk factors, recognising signs and symptoms of illness and managing medications."[6] These kinds of challenges for people living with multiple chronic conditions have direct implications for health services and the way they support patient self-management.[4]

Multimorbidity is common in people who are elderly,[7] malnourished, or poor. Multi-morbidity is common in people with dementia, with the average person with dementia living with five other chronic conditions. The Medication Appropriateness Tool for Comorbid Health in Dementia (MATCH-D) was developed for this reason to support clinicians to manage medications for these people.[8]

See also

References
  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. Wolff JL, Starfield B, Anderson G (November 2002). "Prevalence, expenditures, and complications of multiple chronic conditions in the elderly". Archives of Internal Medicine. 162 (20): 2269–76. doi:10.1001/archinte.162.20.2269. PMID 12418941.
  3. 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.
  4. 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.
  5. 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.
  6. Jowsey T, Jeon YH, Dugdale P, Glasgow NJ, Kljakovic M, Usherwood T (September 2009). "Challenges for co-morbid chronic illness care and policy in Australia: a qualitative study". Australia and New Zealand Health Policy. 6: 22. doi:10.1186/1743-8462-6-22. PMC 2745419. PMID 19735576.
  7. Britt HC, Harrison CM, Miller GC, Knox SA (July 2008). "Prevalence and patterns of multimorbidity in Australia". The Medical Journal of Australia. 189 (2): 72–7. PMID 18637770.
  8. Page AT, Potter K, Clifford R, McLachlan AJ, Etherton-Beer C (October 2016). "Medication appropriateness tool for co-morbid health conditions in dementia: consensus recommendations from a multidisciplinary expert panel". Internal Medicine Journal. 46 (10): 1189–1197. doi:10.1111/imj.13215. PMC 5129475. PMID 27527376.

Further reading

Medication Appropriateness Tool for Comorbid Health Conditions During Dementia (MATCH-D)

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