Abstract
BackgroundGeneral practitioners often care for patients with several concurrent chronic medical conditions (multimorbidity). Recent data suggest that multimorbidity might be observed more often than isolated diseases in primary care. We explored the age- and gender-related prevalence of multimorbidity and compared these estimates to the prevalence estimates of other common specific diseases found in Swiss primary care.MethodsWe analyzed data from the Swiss FIRE (Family Medicine ICPC Research using Electronic Medical Record) project database, representing a total of 509,656 primary care encounters in 98,152 adult patients between January 1, 2009 and July 31, 2011. For each encounter, medical problems were encoded using the second version of the International Classification of primary Care (ICPC-2). We defined chronic health conditions using 147 pre-specified ICPC-2 codes and defined multimorbidity as 1) two or more chronic health conditions from different ICPC-2 rubrics, 2) two or more chronic health conditions from different ICPC-2 chapters, and 3) two or more medical specialties involved in patient care. We compared the prevalence estimates of multimorbidity defined by the three methodologies with the prevalence estimates of common diseases encountered in primary care.ResultsOverall, the prevalence estimates of multimorbidity were similar for the three different definitions (15% [95%CI 11-18%], 13% [95%CI 10-16%], and 14% [95%CI 11-17%], respectively), and were higher than the prevalence estimates of any specific chronic health condition (hypertension, uncomplicated 9% [95%CI 7-11%], back syndrome with and without radiating pain 6% [95%CI 5-7%], non-insulin dependent diabetes mellitus 3% [95%CI 3-4%]), and degenerative joint disease 3% [95%CI 2%-4%]). The prevalence estimates of multimorbidity rose more than 20-fold with age, from 2% (95%CI 1-2%) in those aged 20–29 years, to 38% (95%CI 31-44%) in those aged 80 or more years. The prevalence estimates of multimorbidity were similar for men and women (15% vs. 14%, p=0.288).ConclusionsIn primary care, prevalence estimates of multimorbidity are higher than those of isolated diseases. Among the elderly, more than one out of three patients suffer from multimorbidity. Management of multimorbidity is a principal concern in this vulnerable patient population.
Highlights
General practitioners often care for patients with several concurrent chronic medical conditions
Studies from the United States and Canada [6,7,8], Australia [9], and several European countries [10,11] report an increasing prevalence of multimorbidity with age, but the figures vary widely due to different patient populations, study settings, and definitions of multimorbidity [6,9,10,11]
We provide the prevalence estimates of chronic health conditions and multimorbidity stratified by age and gender
Summary
General practitioners often care for patients with several concurrent chronic medical conditions (multimorbidity). A chronic health condition is a term that includes both, chronic diseases that require ongoing medical care, and persisting impairments (deficit in vision or hearing, orthopedic impairment) that limit the person’s functionality [2,3]. Studies from the United States and Canada [6,7,8], Australia [9], and several European countries [10,11] report an increasing prevalence of multimorbidity with age, but the figures vary widely due to different patient populations, study settings, and definitions of multimorbidity (i.e., the medical conditions taken into account and the number of medical condition required to define multimorbidity) [6,9,10,11]. In Switzerland, figures regarding prevalence of multimorbidity in primary care settings are entirely lacking
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