Abstract
BackgroundMultimorbidity is increasingly being recognized as a serious public health concern. Research into its determinants, prevalence, and management is needed and as the risk of experiencing multiple chronic conditions increases over time, attention should be given to investigating the development of multimorbidity through prospective cohort design studies. Here we examine the baseline patterns of multimorbidity and their association with health outcomes for residents in Yorkshire, England using data from the Yorkshire Health Study.MethodsBaseline data from the Yorkshire Health Study (YHS) was collected from 27,806 patients recruited between 2010 and 2012. A two-stage sampling strategy was implemented which first involved recruiting 43 general practice surgeries and then having them consent to mailing invitations to their patients to complete postal or online questionnaires. The questionnaire collected information on chronic health conditions, demographics, health-related behaviours, healthcare and medication usage, and a range of other health related variables. Descriptive statistics (chi-square and t tests) were used to examine associations between these variables and multimorbidity.ResultsIn the YHS cohort, 10,332 participants (37.2 %) reported having at least two or more long-term health conditions (multimorbidity). Older age, BMI and deprivation were all positively associated with multimorbidity. Nearly half (45.7 %) of participants from the most deprived areas experienced multimorbidity. Based on the weighted sample, average health-related quality of life decreased with the number of health conditions reported; the mean EQ-5D score for participants with no conditions was 0.945 compared to 0.355 for participants with five or more. The mean number of medications used for those without multimorbidity was 1.81 (range 1-13, SD = 1.25) compared to 3.81 (range 1-14, SD = 2.44) for those with at least two long-term conditions and 7.47 (range 1-37, SD = 7.47) for those with 5+ conditions.ConclusionPatterns of multimorbidity within the Yorkshire Health Study support research on multimorbidity within previous observational cross-sectional studies. The YHS provides both a facility for participant recruitment to intervention trials, and a large population-based longitudinal cohort for observational research. It is planned to continue to record chronic conditions and other health related behaviours in future waves which will be useful for examining determinants and trends in chronic disease and multimorbidity.
Highlights
Multimorbidity is increasingly being recognized as a serious public health concern
Living with two or more chronic conditions has increasingly become more common as people age, leading to increased financial pressures on healthcare systems and treatment burden for those living with multimorbidities
Based on a simple multimorbidity definition, overall we found that 37 % of participants sampled in the Yorkshire Health Study had experienced multimorbidity
Summary
Multimorbidity is increasingly being recognized as a serious public health concern. Research into its determinants, prevalence, and management is needed and as the risk of experiencing multiple chronic conditions increases over time, attention should be given to investigating the development of multimorbidity through prospective cohort design studies. Living with two or more chronic conditions has increasingly become more common as people age, leading to increased financial pressures on healthcare systems and treatment burden for those living with multimorbidities. The needs of these patients are complex, with those experiencing different conditions needing to attend multiple appointments with various doctors, while managing several medications [2]. Multimorbidity is most commonly defined as the coexistence of two or more chronic conditions [5, 8, 9] These conditions can range across different long-term, disorders, illnesses, and health problems [3, 8,9,10]. This is based on the argument that multimorbidities may be a better construct for primary care when the focus is on the individual as a whole compared to comorbidity which may be more useful in specialist care where the emphasis is on an index disease [8]
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