Abstract
BackgroundManaging multiple chronic and acute conditions in patients with multimorbidity requires setting medical priorities. How family practitioners (FPs) rank medical priorities between highly, moderately, or rarely prevalent chronic conditions (CCs) has never been described. The authors hypothesised that there was no relationship between the prevalence of CCs and their medical priority ranking in individual patients with multimorbidity.AimTo describe FPs’ medical priority ranking of conditions relative to their prevalence in patients with multimorbidity.Design & settingThis cross-sectional study of 100 FPs in Switzerland included patients with ≥3 CCs on a predefined list of 75 items from the International Classification of Primary Care 2 (ICPC-2); other conditions could be added. FPs ranked all conditions by their medical priority.MethodPriority ranking and distribution were calculated for each condition separately and for the top three priorities together.ResultsThe sample contained 888 patients aged 28–98 years (mean 73), of which 48.2% were male. Included patients had 3–19 conditions (median 7; interquantile range [IQR] 6–9). FPs used 74/75 CCs from the predefined list, of which 27 were highly prevalent (>5%). In total, 336 different conditions were recorded. Highly prevalent CCs were only the top medical priority in 66%, and the first three priorities in 33%, of cases. No correlation was found between prevalence and the ranking of medical priorities.ConclusionFPs faced a great diversity of different conditions in their patients with multimorbidity, with nearly every condition being found at nearly every rank of medical priority, depending on the patient. Medical priority ranking was independent of the prevalence of CCs.
Highlights
IntroductionMultimorbidity, defined as the co-occurrence of more than two or three chronic conditions (CCs) in one person, is increasingly prevalent as global populations age.[1,2,3] Multimorbidity is often present in well-described patterns of highly prevalent CCs.[4,5,6,7,8,9] The most frequent patterns associate cardiovascular diseases and their risk factors, metabolic syndromes (such as diabetes and obesity), pulmonary diseases, psychological disorders (such as depression and anxiety), and osteoarthritic pain.[10] the prevalence of multimorbidity varies greatly depending on definitions, the CCs included, study design, populations, measures, and outcomes.[1,11,12,13,14,15,16]
Multimorbidity, defined as the co-occurrence of more than two or three chronic conditions (CCs) in one person, is increasingly prevalent as global populations age.[1,2,3] Multimorbidity is often present in well-described patterns of highly prevalent CCs.[4,5,6,7,8,9] The most frequent patterns associate cardiovascular diseases and their risk factors, metabolic syndromes, pulmonary diseases, psychological disorders, and osteoarthritic pain.[10]
No relationship was found between the medical priority ranking of different chronic or acute conditions and their prevalence
Summary
Multimorbidity, defined as the co-occurrence of more than two or three chronic conditions (CCs) in one person, is increasingly prevalent as global populations age.[1,2,3] Multimorbidity is often present in well-described patterns of highly prevalent CCs.[4,5,6,7,8,9] The most frequent patterns associate cardiovascular diseases and their risk factors, metabolic syndromes (such as diabetes and obesity), pulmonary diseases, psychological disorders (such as depression and anxiety), and osteoarthritic pain.[10] the prevalence of multimorbidity varies greatly depending on definitions, the CCs included, study design, populations, measures, and outcomes.[1,11,12,13,14,15,16]. Managing multiple chronic and acute conditions in patients with multimorbidity requires setting medical priorities. How family practitioners (FPs) rank medical priorities between highly, moderately, or rarely prevalent chronic conditions (CCs) has never been described. The authors hypothesised that there was no relationship between the prevalence of CCs and their medical priority ranking in individual patients with multimorbidity
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