Treatment burden in complex versus simple multimorbidity: nationwide cross-sectional study in Japan

Area of Science:

• Gerontology
• Public Health
• Clinical Medicine

Background:

• Complex multimorbidity, defined as three or more long-term conditions affecting at least three body systems, is a recent concept in medical literature.
• The clinical utility of complex multimorbidity in identifying patients with heightened care needs remains under investigation.
• Understanding the distinction between complex and simple multimorbidity is crucial for effective patient management.

Purpose of the Study:

• To compare the treatment burden experienced by patients with complex multimorbidity versus those with simple multimorbidity.
• To provide empirical evidence supporting the concept of complex multimorbidity as a distinct clinical entity.
• To inform strategies aimed at mitigating treatment burden in patients with multiple chronic conditions.

Main Methods:

• A nationwide cross-sectional survey of the Japanese adult population was conducted.
• The Multimorbidity Treatment Burden Questionnaire (MTBQ) was used to assess high treatment burden.
• Multivariable modified Poisson regression analysis was employed to adjust for potential confounders.

Main Results:

• Out of 1341 participants, 28.6% had multimorbidity and 9.7% had complex multimorbidity.
• Complex multimorbidity prevalence increased with age.
• Complex multimorbidity was significantly associated with a higher treatment burden (adjusted prevalence ratio = 1.47, 95% CI: 1.14-1.90) compared to simple multimorbidity.

Conclusions:

• Patients with complex multimorbidity face a greater treatment burden than those with simple multimorbidity.
• The findings support the conceptualization of complex multimorbidity for identifying patients with complex healthcare requirements.
• Identifying patients with complex multimorbidity and reducing their treatment burden may enhance health outcomes.