BMJ  2007;334:1128 (2 June), doi:10.1136/bmj.39226.427095.3A

Letters

Multimorbidity's many challenges

A research priority in the UK

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

Further to the three research areas Fortin et al identify for investigation,1 four additional aspects of multimorbidity are also relevant. Firstly, acute conditions also contribute to comorbidity, and there is no reason for their exclusion. Secondly, comorbidity is of particular relevance to primary care, which is person focused and not disease focused.2 Thirdly, research on the mechanisms through which comorbid conditions interact is important for understanding the genesis of multimorbidity as well as its management; and fourthly, the implications of comorbidity matter in the assessment of quality of primary care and its financial restitution. The current financial incentives for general practitioners to provide high quality care focus almost exclusively on single conditions,3 increasingly the likelihood of fragmented care.4 Nevertheless, research from the United States shows that when patients have multiple comorbid conditions, the care for each may be better than when they have single conditions.5

Measuring comorbidity with the adjusted . . . [Full text of this article]

Jose M Valderas, clinical lecturer1, Barbara Starfield, university distinguished professor2, Martin Roland, director3

1 National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, 2 Johns Hopkins School of Public Health, Baltimore, MD 21205, USA, 3 NIHR School for Primary Care Research, University of Manchester, Manchester M13 9PL

jose.valderas@manchester.ac.uk


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Relevant Article

Multimorbidity's many challenges
Martin Fortin, Hassan Soubhi, Catherine Hudon, Elizabeth A Bayliss, and Marjan van den Akker
BMJ 2007 334: 1016-1017. [Extract] [Full Text] [PDF]

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