https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60240-2.pdf

Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)61415-9.pdf

Depression, chronic diseases, and decrements in health: results from the World Health Surveys

Depression, chronic diseases, and decrements in health : results from the world health surveys. Commentary

Measuring Health: A Guide to Rating Scales and Questionnaires

This presentation will set out the eScience agenda by explaining the current scientific data deluge and the case for a “Fourth Paradigm” for scientific exploration. Examples of data intensive science will be used to illustrate the explosion of data and the associated new challenges for data capture, curation, analysis, and sharing. The role of cloud computing, collaboration services, and research repositories will be discussed.

/pdf/the-fourth-paradigm-data-intensive-scientific-discovery-2j2x5xux2r.pdf

The Fourth Paradigm: Data-Intensive Scientific Discovery

PURPOSE There are few valid data that describe the extent of multimorbidity in primary care patients. The purpose of this study was to estimate its prevalence in family practice patients by counting the number of chronic medical conditions and using a measure that considers the severity of these conditions, the Cumulative Illness Rating Scale (CIRS). METHODS The study was carried out in the Saguenay region (Quebec, Canada) in 2003. The participation of adult patients from 21 family physicians was solicited during consecutive consultation periods. A research nurse reviewed medical records and extracted the data regarding chronic illnesses. For each chronic condition, a severity rating was determined in accordance with the CIRS scoring guidelines. RESULTS The sample consisted of 320 men and 660 women. Overall, 9 of 10 patients had more than 1 chronic condition. The prevalence of having 2 or more medical conditions in the 18- to 44-year, 45- to 64-year, and 65-year and older age-groups was, respectively, 68%, 95%, and 99% among women and 72%, 89%, and 97% among men. The mean number of conditions and mean CIRS score also increased significantly with age. CONCLUSIONS Whether measured by simply counting the number of conditions or using the CIRS, the prevalence of multimorbidity is quite high and increases significantly with age in both men and women. Patients with multimorbidity seen in family practice represent the rule rather than the exception.

https://www.annfammed.org/content/annalsfm/3/3/223.full.pdf

Prevalence of Multimorbidity Among Adults Seen in Family Practice

There are few valid data that describe the extent of multimorbidity in primary care patients. The purpose of this study was to estimate its prevalence in family practice patients by counting the number of chronic medical conditions and using a measure that considers the severity of these conditions, the Cumulative Illness Rating Scale (CIRS).

Background
Many patients with several concurrent medical conditions (multimorbidity) are seen in the primary care setting. A thorough understanding of outcomes associated with multimorbidity would benefit primary care workers of all disciplines. The purpose of this systematic review was to clarify the relationship between the presence of multimorbidity and the quality of life (QOL) or health-related quality of life (HRQOL) of patients seen, or likely to be seen, in the primary care setting.

/pdf/multimorbidity-and-quality-of-life-in-primary-care-a-2zu5kououz.pdf

Multimorbidity and quality of life in primary care: a systematic review

Many patients with several concurrent medical conditions (multimorbidity) are seen in the primary care setting. A thorough understanding of outcomes associated with multimorbidity would benefit primary care workers of all disciplines. The purpose of this systematic review was to clarify the relationship between the presence of multimorbidity and the quality of life (QOL) or health-related quality of life (HRQOL) of patients seen, or likely to be seen, in the primary care setting.

Previous studies about the association of multimorbidity and the health-related quality of life (HRQOL) in primary-care patients are limited because of their reliance on simple counts of diseases from a limited list of diseases and their failure to assess the severity of disease. We evaluated the association while taking into account the severity of the medical conditions based on the Cumulative Illness Rating Scale (CIRS) score, and controlling for potential confounders (age, sex, household income, education, self-perception of economic status, number of people living in the same dwelling, and perceived social support). We randomly selected 238 patients to construct quintiles of increasing multimorbidity (CIRS). Patients completed the 36-item Medical Outcomes study questionnaire (SF-36) to evaluate their HRQOL. Applying bivariate and multivariate linear regression analyses, we used the CIRS as either a continuous or a categorical (quintiles) variable. Use of the CIRS revealed a stronger association of HRQOL with multimorbidity than using a simple count of chronic conditions. Physical more than mental health deteriorated with increasing multimorbidity. Perceived social support and self-perception of economic status were significantly related to all scales of the SF-36 (p < 0.05). Increased multimorbidity adversely affected HRQOL in primary-care adult patients, even when confounding variables were controlled for.

Lise Lapointe

Papers

Prevalence of Multimorbidity Among Adults Seen in Family Practice

Prevalence of Multimorbidity Among Adults Seen in Family Practice

Multimorbidity and quality of life in primary care: a systematic review

Multimorbidity and quality of life in primary care: a systematic review

Relationship between multimorbidity and health-related quality of life of patients in primary care.