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[Increased multimorbidity in patients in general practice in the period 2003-2009]
Margot A J B Tacken1, Wim Opstelten, Ilse Vossen
1Universitair Medisch Centrum St Radboud, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, the Netherlands. m.tacken@iq.umcn.nl
Insights
Chronic diseases and multimorbidity are increasing in primary care. This trend affects all adult age groups and is projected to exceed 30% for older patients by 2015.
Area of Science:
- General Practice
- Epidemiology
- Public Health
Context:
- Primary care settings face increasing patient complexity.
- Chronic diseases like pulmonary disease, cardiovascular disease, and diabetes are prevalent.
- Understanding multimorbidity trends is crucial for healthcare planning.
Purpose:
- To determine the prevalence of chronic multimorbidity in primary care.
- To assess the increase in chronic disease and multimorbidity from 2003 to 2009.
Summary:
- A descriptive longitudinal study analyzed a national general practice database (LINH) from 2003-2009.
- Prevalence of at least one chronic condition rose from 12.6% to 15.0%.
- Multimorbidity prevalence increased from 15.9% to 18.3% across adult age groups and studied conditions.
Impact:
- Projected multimorbidity in patients over 65 with these conditions may exceed 30% by 2015 if current trends persist.
- Highlights the growing burden of complex chronic conditions in primary care.
- Informs resource allocation and intervention strategies for managing multimorbidity.
Objective:
To determine the prevalence of chronic multimorbidity and its increase in primary care.
Design:
Descriptive longitudinal study.
Method:
We selected patients suffering from chronic pulmonary disease, chronic cardiovascular disease, or diabetes from a national representative general practice research database (LINH). For each year in the period 2003-2009, we calculated the prevalence of these separate conditions. We subsequently assessed the prevalence of multimorbidity and its increase for 4 different age groups (0-14, 15-44, 45-64, ≥ 65 years).
Results:
The percentage of all patients suffering from at least 1 of these chronic conditions increased from 12.6% in 2003 to 15.0% in 2009, an increase of almost 20%. The multimorbidity among these patients rose from 15.9% in 2003 to 18.3% in 2009. This increase in multimorbidity was found in all 3 chronic conditions under study and in all adult age groups. To what extent this increase was caused by improvements in morbidity registration could not be identified.
Conclusion:
There appears to be a considerable increase in recent years in the prevalence of chronic diseases; multimorbidity appears also to have increased. If this trend continues, in 2015 the multimorbidity among patients over 65 years of age with diabetes, chronic pulmonary and/or cardiovascular disease will be more than 30%.
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