Journal ArticleDOI
Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study
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The findings challenge the single-disease framework by which most health care, medical research, and medical education is configured, and a complementary strategy is needed, supporting generalist clinicians to provide personalised, comprehensive continuity of care, especially in socioeconomically deprived areas.About:
This article is published in The Lancet.The article was published on 2012-07-07. It has received 4839 citations till now. The article focuses on the topics: Comorbidity & Health services research.read more
Citations
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The World report on ageing and health: a policy framework for healthy ageing.
John R. Beard,Alana Officer,Islene Araujo de Carvalho,Ritu Sadana,Anne Margriet Pot,Jean-Pierre Michel,Peter Lloyd-Sherlock,JoAnne E. Epping-Jordan,Geeske Peeters,Wahyu Retno Mahanani,Jotheeswaran Amuthavalli Thiyagarajan,Somnath Chatterji +11 more
TL;DR: The first World report on ageing and health is released, reviewing current knowledge and gaps and providing a public health framework for action, built around a redefinition of healthy ageing that centres on the notion of functional ability.
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How to increase value and reduce waste when research priorities are set
Iain Chalmers,Michael B. Bracken,Ben Djulbegovic,Silvio Garattini,Jonathan Grant,A Metin Gülmezoglu,David W. Howells,John P. A. Ioannidis,Sandy Oliver +8 more
TL;DR: This report discusses how avoidable waste can be considered when research priorities are set and recommends ways to improve the yield from basic research, and the transparency of processes by which funders prioritise important uncertainties should be increased.
Journal ArticleDOI
Racism and Health I: Pathways and Scientific Evidence
TL;DR: A large and growing body of evidence indicates that experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioral patterns that increase health risks.
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Microglial priming in neurodegenerative disease.
V. Hugh Perry,Clive Holmes +1 more
TL;DR: The concept of microglial priming, and the subsequent exaggerated response of these cells to secondary systemic inflammation, opens the way to treat neurodegenerative diseases by targeting systemic disease or interrupting the signalling pathways that mediate the CNS response to systemic inflammation.
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Prevalence, Determinants and Patterns of Multimorbidity in Primary Care: A Systematic Review of Observational Studies
Concepció Violan,Quintí Foguet-Boreu,Gemma Flores-Mateo,Chris Salisbury,Jeanet W. Blom,Michael H. Freitag,Liam G. Glynn,Christiane Muth,Jose M Valderas +8 more
TL;DR: The limitations of the current evidence base means that further and better designed studies are needed to inform policy, research and clinical practice, with the goal of improving health-related quality of life for patients with multimorbidity.
References
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Relationship between Number of Medical Conditions and Quality of Care
Takahiro Higashi,Neil S. Wenger,Neil S. Wenger,John L. Adams,Constance H. Fung,Constance H. Fung,Martin Roland,Elizabeth A. McGlynn,David Reeves,Steven M. Asch,Steven M. Asch,Eve A. Kerr,Paul G. Shekelle,Paul G. Shekelle +13 more
TL;DR: The quality of care, measured according to whether patients were offered recommended services, increases as a patient's number of chronic conditions increases.
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The inverse care law today.
TL;DR: The results of a review of trends in coronary mortality indicate that about half of the observed reduction in mortality could have been due to clinical interventions, and many of the most effective interventions are applicable to large numbers of people and have the potential to make great contributions to improving public health.
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Comorbidity and guidelines: conflicting interests.
TL;DR: The fourth epidemiological transition is characterised by an unprecedented increase in chronic degenerative disorders, and chronic disease is a particularly important area in which to ensure high-quality care.
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Continuity of care matters
TL;DR: The current focus on increasing access makes it more difficult for patients to see the same doctor, but Bruce Guthrie and colleagues argue that relationships between doctors and patients are central to good care.
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Primary Care Clinicians’ Experiences with Treatment Decision-Making for Older Persons with Multiple Conditions
TL;DR: The experiences of practicing clinicians suggest that they struggle with the uncertainties of applying disease-specific guidelines to their older patients with multiple conditions and need more data, alternative guidelines, approaches to reconciling their own and their patients' priorities, the support of their subspecialist colleagues, and an altered reimbursement system to improve decision making.