BMJ  2007;334:1016-1017 (19 May), doi:10.1136/bmj.39201.463819.2C

Editorials

Multimorbidity's many challenges

Time to focus on the needs of this vulnerable and growing population

The first 150 words of the full text of this article appear below.

Patients with multiple conditions are the rule rather than the exception in primary care.¹ In a recent study of 21 family practices in the Saguenay region, Quebec, the prevalence of multimorbidity was 69% in 18-44 year olds, 93% in 45-64 year olds, and 98% in those aged over 65, and the number of chronic conditions varied from 2.8 in the youngest to 6.4 in the oldest.¹ Other countries report a similar burden.^{2 3} The number of Americans with multimorbidity is estimated to rise from 60 million in 2000 to 81 million by 2020.⁴

Having multiple chronic medical conditions is associated with poor outcomes: patients have decreased quality of life,⁵ psychological distress,⁶ longer hospital stays, more postoperative complications, a higher cost of care, and higher mortality. Multimorbidity also affects processes of care and may result in complex self care needs⁷; challenging organisational problems (accessibility, coordination, consultation time); polypharmacy; increased use of . . . [Full text of this article]

¹ Department of Family Medicine, University of Sherbrooke, J1H 5N4, Quebec, Canada, ² Department of Family Medicine, University of Colorado Health Sciences Center, Denver, CO, 80237, USA, ³ Department of General Practice, Maastricht University, 6200 MD, Netherlands

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