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Multimorbidity patterns in a primary care population aged 55 years and over
Judith Sinnige1, Joke C Korevaar2, Gert P Westert3
1NIVEL, Netherlands Institute for Health Services Research, 3500 BN Utrecht, The Netherlands, Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, 6500 HB Nijmegen, The Netherlands, and j.sinnige@nivel.nl.
Family Practice
|June 5, 2015
Summary
Understanding prevalent multimorbidity patterns in primary care is crucial. This study identified common disease combinations in older adults, informing better patient management strategies.
Area of Science:
- Gerontology
- Primary Care Medicine
- Epidemiology
Background:
- Effective management of multimorbidity in primary care requires understanding prevalent disease patterns.
- Evidence on common and distinctive multimorbidity patterns is needed for clinical practice.
Purpose of the Study:
- To identify common and distinctive multimorbidity patterns in patients aged 55 years and older.
- To differentiate patterns between age groups (55-69 and ≥70 years).
Main Methods:
- Analysis of clinical data from 120,480 patients across 158 general practices (2002-2011).
- Calculation of prevalence rates and prevalence ratios for multimorbidity and specific disease combinations.
- Multilevel modeling adjusted for practice, disease count, and registration period.
Main Results:
- Overall adjusted multimorbidity rate was 86% in patients with chronic conditions; 38% had ≥4 chronic diseases.
- Significant disease patterns identified, e.g., chronic obstructive pulmonary disease-cardiac dysrhythmia (ratio 7.7) in heart failure patients.
- Distinct patterns found for diabetes mellitus, dementia, and migraine, with high prevalence ratios for co-occurring conditions.
Conclusions:
- Knowledge of comprehensive disease patterns can enhance multimorbidity management in primary care for elderly patients.
- Guideline developers must consider the complexity of multimorbidity.
- Focusing on patient-centered care is essential given the complexity of multimorbidity.
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