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Multimorbidity Frameworks Impact Prevalence and Relationships with Patient-Important Outcomes
Lauren E Griffith1, Anne Gilsing1, Dee Mangin2
1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Journal of the American Geriatrics Society
|April 9, 2019
Summary
Understanding how chronic conditions are categorized is crucial for accurately estimating multimorbidity (two or more chronic conditions) prevalence and its impact on patient outcomes. Including symptoms in frameworks significantly enhances these associations.
Area of Science:
- Gerontology and Public Health
- Chronic Disease Epidemiology
- Health Services Research
Background:
- Multimorbidity, defined as the coexistence of two or more chronic conditions, is a growing public health concern.
- Estimating multimorbidity prevalence and its impact on functional outcomes can vary significantly based on the definitions and frameworks used.
- Patient-important functional outcomes include disability, social participation restriction, and self-rated physical and mental health.
Purpose of the Study:
- To investigate how different frameworks and categorization of chronic conditions influence multimorbidity prevalence estimates.
- To examine the association between multimorbidity, defined by various frameworks, and patient-important functional outcomes.
Main Methods:
- Utilized baseline data from a population-based cohort study of 51,338 Canadian adults aged 45-85 years.
- Chronic conditions were categorized into diseases, risk factors, and symptoms across three frameworks.
- Weighted logistic regression models assessed the impact of different frameworks on multimorbidity prevalence and its association with functional outcomes.
Main Results:
- Multimorbidity prevalence estimates varied widely (33.5% to 60.6%) depending on the framework used.
- Inclusion of risk factors increased prevalence estimates, while inclusion of symptoms increased both prevalence and associations with most functional outcomes.
- Frameworks including symptoms demonstrated stronger associations with disability, social participation restriction, and self-rated physical health.
Conclusions:
- The categorization of chronic conditions significantly impacts multimorbidity prevalence and its relationship with functional outcomes.
- Including symptoms in multimorbidity frameworks is essential for capturing associations with patient-important outcomes.
- Relying solely on the number of diagnoses may underestimate the true burden of multimorbidity and its impact on individuals.
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