Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Jan 28:9:6.
doi: 10.1186/1471-2296-9-6.

Multimorbidity in younger deprived patients: an exploratory study of research and service implications in general practice

Susan M Smith  1 , Atakelet Ferede, Tom O'Dowd
Affiliations

Multimorbidity in younger deprived patients: an exploratory study of research and service implications in general practice

Susan M Smith et al. BMC Fam Pract. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

PubMed Disclaimer

References

    1. Fortin M, Hudon C, Lapointe L, Vanasse A. Multimorbidity is common to family practice: Is it commonly researched? Canadian Family Physician. 2005;51:244–245. - PMC - PubMed
    1. Fortin M, Soubhi H, Hudon C, Bayliss EA, Akker Mvd. Multimorbidity's many challenges. Brit Med J. 2007;334:1016–7. doi: 10.1136/bmj.39201.463819.2C. May 19, 2007. - DOI - PMC - PubMed
    1. Smith SM, O'Dowd T. Chronic diseases: what happens when they come in multiples? Brit J Gen Pract. 2007;57:268–270. - PMC - PubMed
    1. Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of Multimorbidity Among Adults Seen in Family Practice. Ann Fam Med. 2005;3:223–8. doi: 10.1370/afm.272. May 1, 2005. - DOI - PMC - PubMed
    1. Keeping people out of hospital: The challenge of reducing emergency hospital admissions: Dr Foster Intelligence. 2006.

Publication types